Dynamic loading of an extending application

ABSTRACT

An apparatus, system and product including a software agent configured to monitor and interact with a Document Object Model (DOM) of a page of an Electronic Health Record (EHR) system; a runtime infrastructure that is loaded, dynamically, in the page in a first iframe; an EHR-specific EHR adapter that is loaded, dynamically, in the page; and an extending application that is loaded, dynamically, in the page in a second iframe, wherein the EHR-specific EHR adapter is configured to receive EHR-specific instructions from the software agent and communicate converted cross-EHR instructions to the runtime infrastructure, wherein the runtime infrastructure is configured to communicate the converted cross-EHR instructions to the extending application and receive cross-EHR instructions from the extending application, wherein the EHR-specific EHR adapter is configured to obtain the cross-EHR instructions and communicate converted EHR-specific instructions to the software agent.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.17/502,567, filed on Oct. 15, 2021, which is hereby incorporated byreference in its entirety without giving rise to disavowment.

TECHNICAL FIELD

The present disclosure relates to loading of applications in general,and to dynamically loading applications over a data system, inparticular.

BACKGROUND

One or more software modules may be used in order to customize a user'sdisplay. For example, a browser extension may comprise a small softwaremodule for customizing a web browser, a webpage, or the like. Browserstypically allow a variety of extensions to perform user interfacemodifications, ad blocking, and cookie management.

In some cases, a user display may present an interface of one or moreElectronic Health Record (EHR) systems, also referred to as ElectronicMedical Records (EMRs), which may comprise records of medical data of apatient in a digital version. An EHR may contain Protected HealthInformation (PHI) such as the medical and treatment histories ofpatients. Under the US law, PHI information may comprise any informationabout health status, provision of health care, or payment for healthcare that is created or collected by a covered entity (or a businessassociate of a covered entity), and can be linked to a specificindividual. This may be interpreted broadly to include any part of apatient's medical record or payment history.

BRIEF SUMMARY

One exemplary embodiment of the disclosed subject matter is an apparatuscomprising: a software agent configured to monitor and interact with aDocument Object Model (DOM) of a page of an Electronic Health Record(EHR) system; a runtime infrastructure that is loaded, dynamically, inthe page of the EHR system in a first iframe; an EHR-specific EHRadapter that is loaded, dynamically, in the page of the EHR system; andan extending application that is loaded, dynamically, in the page of theEHR system in a second iframe, wherein the EHR-specific EHR adapter isspecifically designed based on the EHR system, wherein the EHR-specificEHR adapter is configured to receive EHR-specific instructions from thesoftware agent and communicate converted cross-EHR instructions to theruntime infrastructure, wherein the runtime infrastructure is configuredto communicate the converted cross-EHR instructions to the extendingapplication, wherein the runtime infrastructure is configured to receivecross-EHR instructions from the extending application, wherein theEHR-specific EHR adapter is configured to obtain the cross-EHRinstructions and communicate converted EHR-specific instructions to thesoftware agent, wherein said apparatus is configured to implement afunctionality that is not provided by the EHR system at least by:monitoring, by the software agent, for an event in the EHR system;notifying, by the software agent, the EHR-specific EHR adapter of theevent via an EHR-specific instruction; translating, by the EHR-specificEHR adapter, the EHR-specific instruction to a converted cross-EHRinstruction that is provided to the extending application via theruntime infrastructure; executing, by the extending application, across-EHR business logic in response to the converted cross-EHRinstruction to determine a cross-EHR response; and translating, by theEHR-specific EHR adapter, the cross-EHR response to a convertedEHR-specific instruction that can be implemented by the software agentover the EHR system.

Optionally, the runtime infrastructure lacks a Graphical User Interface(GUI) representation.

Optionally, the extending application comprises a GUI component, and thebusiness logic is configured to manipulate the GUI component.

Optionally, the extending application is an automation process thatlacks a GUI representation.

Optionally, the runtime infrastructure is configured to: retrieve from aserver a list of applications to be loaded in the page comprising atleast the extending application, wherein the runtime infrastructure isconfigured to dynamically load the extending application in the secondiframe by provisioning a Uniform Resource Locator (URL) to be loaded inthe second iframe, wherein the URL is pointing to a code of theextending application, whereby the apparatus is enabled to load new codeand provision new functionality by changing the code or changing the URLwithout changing the software agent, whereby the apparatus prevents adynamic execution of a string representing client-side code.

Optionally, the list of applications to be loaded is determined based onaccess permissions of a user of the EHR system to applications in anapplication repository.

Optionally, the software agent is configured to inject the first iframein the page of the EHR system and cause the runtime infrastructure to beloaded into the first iframe.

Optionally, the software agent is configured to inject the second iframein the page of the EHR system and enable the runtime infrastructure toload the extending application into the second iframe.

Optionally, the cross-EHR response is configured to perform a UserInterface (UI) manipulation in the page of the EHR system or a dataupdate in the page of the EHR system.

Optionally, the software agent is configured to inject the EHR-specificEHR adapter in the page of the EHR system and load the EHR-specific EHRadapter.

Optionally, the software agent comprises a browser extension that isconfigured to be executed by a browser, wherein the browser isconfigured to render the page of the EHR system.

Optionally, the software agent comprises a desktop agent, wherein theEHR system comprises a desktop-based EHR system, wherein the desktopagent is configured to be executed over the desktop-based EHR system.

Optionally, the runtime infrastructure is configured to retrieve from aserver a list of applications to be loaded in the page, wherein the listof applications to be loaded comprises the extending application and asecond application, wherein the extending application belongs to a firstorganization associated with a first server, wherein the secondapplication belongs to a second organization associated with a secondserver, wherein the runtime infrastructure is configured to dynamicallyload the second application in a third iframe embedded in the page byprovisioning a URL to be loaded in the third iframe, wherein the URL ispointing to a code of the second application.

Optionally, the runtime infrastructure is configured to retrieve from aserver a list of applications to be loaded in the page, wherein the listof applications to be loaded comprises the extending application and asecond application, wherein the extending application belongs to a firstorganization associated with a first server, wherein the secondapplication belongs to a second organization associated with a secondserver, wherein the runtime infrastructure is configured to dynamicallyload the second application in the second iframe by provisioning a URLof the second application to be loaded in the second iframe, wherein theURL of the second application is pointing to a code of the secondapplication, wherein the URL of the second application replaces a URL ofthe extending application.

Optionally, the runtime infrastructure is configured to dynamically loadthe second application in the second iframe in response to a secondevent.

Optionally, the list of applications is available in a marketplace,wherein any provider is enabled to upload a new application to themarketplace, wherein a user of the EHR system is enabled to install in auser device any application from the marketplace.

Optionally, the EHR-specific EHR adapter is configured to indicate tothe software agent an element of interest via an indication, wherein thesoftware agent is configured to monitor the element of interest inresponse to the indication, wherein the software agent is configured tonotify the EHR-specific EHR adapter of the EHR-specific instruction inresponse to monitoring the event, wherein the event is associated to theelement of interest.

Optionally, the software agent is configured to inject the first andsecond iframes in response to determining that the extending applicationis configured to be loaded over the page of the EHR system.

Another exemplary embodiment of the disclosed subject matter is a systemcomprising: a software agent configured to monitor and interact with aDOM of a page of an EHR system; a runtime infrastructure that is loaded,dynamically, in the page of the EHR system in a first iframe; anEHR-specific EHR adapter that is loaded, dynamically, in the page of theEHR system; and an extending application that is loaded, dynamically, inthe page of the EHR system in a second iframe, wherein the EHR-specificEHR adapter is specifically designed based on the EHR system, whereinthe EHR-specific EHR adapter is configured to receive EHR-specificinstructions from the software agent and communicate converted cross-EHRinstructions to the runtime infrastructure, wherein the runtimeinfrastructure is configured to communicate the converted cross-EHRinstructions to the extending application, wherein the runtimeinfrastructure is configured to receive cross-EHR instructions from theextending application, wherein the EHR-specific EHR adapter isconfigured to obtain the cross-EHR instructions and communicateconverted EHR-specific instructions to the software agent, wherein saidsystem is configured to implement a functionality that is not providedby the EHR system at least by: monitoring, by the software agent, for anevent in the EHR system; notifying, by the software agent, theEHR-specific EHR adapter of the event via an EHR-specific instruction;translating, by the EHR-specific EHR adapter, the EHR-specificinstruction to a converted cross-EHR instruction that is provided to theextending application via the runtime infrastructure; executing, by theextending application, a cross-EHR business logic in response to theconverted cross-EHR instruction to determine a cross-EHR response; andtranslating, by the EHR-specific EHR adapter, the cross-EHR response toa converted EHR-specific instruction that can be implemented by thesoftware agent over the EHR system.

Yet another exemplary embodiment of the disclosed subject matter is acomputer program product comprising a non-transitory computer readablemedium retaining program instructions, which program instructions whenread by a processor, cause the processor to: obtain a software agentconfigured to monitor and interact with a DOM of a page of an EHRsystem; obtain a runtime infrastructure that is loaded, dynamically, inthe page of the EHR system in a first iframe; obtain an EHR-specific EHRadapter that is loaded, dynamically, in the page of the EHR system; andobtain an extending application that is loaded, dynamically, in the pageof the EHR system in a second iframe, wherein the EHR-specific EHRadapter is specifically designed based on the EHR system, wherein theEHR-specific EHR adapter is configured to receive EHR-specificinstructions from the software agent and communicate converted cross-EHRinstructions to the runtime infrastructure, wherein the runtimeinfrastructure is configured to communicate the converted cross-EHRinstructions to the extending application, wherein the runtimeinfrastructure is configured to receive cross-EHR instructions from theextending application, wherein the EHR-specific EHR adapter isconfigured to obtain the cross-EHR instructions and communicateconverted EHR-specific instructions to the software agent, wherein saidprocessor is configured to implement a functionality that is notprovided by the EHR system at least by: monitoring, by the softwareagent, for an event in the EHR system; notifying, by the software agent,the EHR-specific EHR adapter of the event via an EHR-specificinstruction; translating, by the EHR-specific EHR adapter, theEHR-specific instruction to a converted cross-EHR instruction that isprovided to the extending application via the runtime infrastructure;executing, by the extending application, a cross-EHR business logic inresponse to the converted cross-EHR instruction to determine a cross-EHRresponse; and translating, by the EHR-specific EHR adapter, thecross-EHR response to a converted EHR-specific instruction that can beimplemented by the software agent over the EHR system.

Yet another exemplary embodiment of the disclosed subject matter is anapparatus comprising: a browser extension configured to monitor andinteract with a DOM of a page of an EHR system, wherein the browserextension is configured to be executed by a browser, wherein the browseris configured to render the page of the EHR system; a runtimeinfrastructure that is loaded, dynamically, in the page of the EHRsystem in a first iframe, wherein the runtime infrastructure lacks a GUIrepresentation; an EHR-specific EHR adapter that is loaded, dynamically,in the page of the EHR system; and an extending application that isloaded, dynamically, in the page of the EHR system in a second iframe,wherein the browser extension is configured to inject the first iframein the page of the EHR system and cause the runtime infrastructure to beloaded into the first iframe, wherein the browser extension isconfigured to inject the second iframe in the page of the EHR system andenable the runtime infrastructure to load the extending application intothe second iframe, wherein the EHR-specific EHR adapter is specificallydesigned based on the EHR system, wherein the EHR-specific EHR adapteris configured to receive EHR-specific instructions from the browserextension and communicate converted cross-EHR instructions to theruntime infrastructure, wherein the runtime infrastructure is configuredto communicate the converted cross-EHR instructions to the extendingapplication, wherein the runtime infrastructure is configured to receivecross-EHR instructions from the extending application, wherein theEHR-specific EHR adapter is configured to obtain the cross-EHRinstructions and communicate converted EHR-specific instructions to thebrowser extension, wherein said apparatus is configured to implement afunctionality that is not provided by the EHR system at least by:monitoring, by the browser extension, for an event in the EHR system;notifying, by the browser extension, the EHR-specific EHR adapter of theevent via an EHR-specific instruction; translating, by the EHR-specificEHR adapter, the EHR-specific instruction to a converted cross-EHRinstruction that is provided to the extending application via theruntime infrastructure; executing, by the extending application, across-EHR business logic in response to the converted cross-EHRinstruction to determine a cross-EHR response; and translating, by theEHR-specific EHR adapter, the cross-EHR response to a convertedEHR-specific instruction that can be implemented by the browserextension over the EHR system.

Optionally, the extending application comprises a GUI component, whereinthe business logic is configured to manipulate the GUI component.

Optionally, the extending application is an automation process, whereinthe automation process lacks a GUI representation.

Optionally, the runtime infrastructure is configured to: retrieve from aserver a list of applications to be loaded in the page, wherein the listof applications to be loaded comprises at least the extendingapplication, wherein the runtime infrastructure is configured todynamically load the extending application in the second iframe byprovisioning a URL to be loaded in the second iframe, wherein the URL ispointing to a code of the extending application, whereby the apparatusis enabled to load new code and provision new functionality by changingthe code or changing the URL without changing the browser extension,whereby the apparatus prevents a dynamic execution of a stringrepresenting client-side code.

Optionally, the list of applications to be loaded is determined based onaccess permissions of a user of the EHR system to applications in anapplication repository.

Optionally, the cross-EHR response is configured to perform a UImanipulation in the page of the EHR system or a data update in the pageof the EHR system.

Optionally, the browser extension is configured to inject theEHR-specific EHR adapter in the page of the EHR system and load theEHR-specific EHR adapter.

Optionally, the runtime infrastructure is configured to retrieve from aserver a list of applications to be loaded in the page, wherein the listof applications to be loaded comprises the extending application and asecond application, wherein the extending application belongs to a firstorganization associated with a first server, wherein the secondapplication belongs to a second organization associated with a secondserver, wherein the runtime infrastructure is configured to dynamicallyload the second application in a third iframe embedded in the page byprovisioning a URL to be loaded in the third iframe, wherein the URL ispointing to a code of the second application.

Optionally, the runtime infrastructure is configured to retrieve from aserver a list of applications to be loaded in the page, wherein the listof applications to be loaded comprises the extending application and asecond application, wherein the extending application belongs to a firstorganization associated with a first server, wherein the secondapplication belongs to a second organization associated with a secondserver, wherein the runtime infrastructure is configured to dynamicallyload the second application in the second iframe by provisioning a URLof the second application to be loaded in the second iframe, wherein theURL of the second application is pointing to a code of the secondapplication, wherein the URL of the second application replaces a URL ofthe extending application.

Optionally, the runtime infrastructure is configured to dynamically loadthe second application in the second iframe in response to a secondevent.

Optionally, a list of applications is available in a marketplace,wherein any provider is enabled to upload a new application to themarketplace, wherein a user of the EHR system is enabled to install in auser device any application from the marketplace.

Optionally, the EHR-specific EHR adapter is configured to indicate tothe browser extension an element of interest via an indication, whereinthe browser extension is configured to monitor the element of interestin response to the indication, wherein the browser extension isconfigured to notify the EHR-specific EHR adapter of the EHR-specificinstruction in response to monitoring the event, wherein the event isassociated to the element of interest.

Optionally, the browser extension is configured to inject the first andsecond iframes in response to determining that the extending applicationis configured to be loaded over the page of the EHR system.

Yet another exemplary embodiment of the disclosed subject matter is asystem comprising: a browser extension configured to monitor andinteract with a DOM of a page of an EHR system, wherein the browserextension is configured to be executed by a browser, wherein the browseris configured to render the page of the EHR system; a runtimeinfrastructure that is loaded, dynamically, in the page of the EHRsystem in a first iframe, wherein the runtime infrastructure lacks a GUIrepresentation; an EHR-specific EHR adapter that is loaded, dynamically,in the page of the EHR system; and an extending application that isloaded, dynamically, in the page of the EHR system in a second iframe,wherein the browser extension is configured to inject the first iframein the page of the EHR system and cause the runtime infrastructure to beloaded into the first iframe, wherein the browser extension isconfigured to inject the second iframe in the page of the EHR system andenable the runtime infrastructure to load the extending application intothe second iframe, wherein the EHR-specific EHR adapter is specificallydesigned based on the EHR system, wherein the EHR-specific EHR adapteris configured to receive EHR-specific instructions from the browserextension and communicate converted cross-EHR instructions to theruntime infrastructure, wherein the runtime infrastructure is configuredto communicate the converted cross-EHR instructions to the extendingapplication, wherein the runtime infrastructure is configured to receivecross-EHR instructions from the extending application, wherein theEHR-specific EHR adapter is configured to obtain the cross-EHRinstructions and communicate converted EHR-specific instructions to thebrowser extension, wherein said system is configured to implement afunctionality that is not provided by the EHR system at least by:monitoring, by the browser extension, for an event in the EHR system;notifying, by the browser extension, the EHR-specific EHR adapter of theevent via an EHR-specific instruction; translating, by the EHR-specificEHR adapter, the EHR-specific instruction to a converted cross-EHRinstruction that is provided to the extending application via theruntime infrastructure; executing, by the extending application, across-EHR business logic in response to the converted cross-EHRinstruction to determine a cross-EHR response; and translating, by theEHR-specific EHR adapter, the cross-EHR response to a convertedEHR-specific instruction that can be implemented by the browserextension over the EHR system.

Yet another exemplary embodiment of the disclosed subject matter is acomputer program product comprising a non-transitory computer readablemedium retaining program instructions, which program instructions whenread by a processor, cause the processor to: monitor and interact with aDOM of a page of an EHR system using a browser extension, wherein thebrowser extension is configured to be executed by a browser, wherein thebrowser is configured to render the page of the EHR system; dynamicallyload a runtime infrastructure in the page of the EHR system in a firstiframe, wherein the runtime infrastructure lacks a GUI representation;dynamically load an EHR-specific EHR adapter in the page of the EHRsystem; and dynamically load an extending application in the page of theEHR system in a second iframe, wherein the browser extension isconfigured to inject the first iframe in the page of the EHR system andcause the runtime infrastructure to be loaded into the first iframe,wherein the browser extension is configured to inject the second iframein the page of the EHR system and enable the runtime infrastructure toload the extending application into the second iframe, wherein theEHR-specific EHR adapter is specifically designed based on the EHRsystem, wherein the EHR-specific EHR adapter is configured to receiveEHR-specific instructions from the browser extension and communicateconverted cross-EHR instructions to the runtime infrastructure, whereinthe runtime infrastructure is configured to communicate the convertedcross-EHR instructions to the extending application, wherein the runtimeinfrastructure is configured to receive cross-EHR instructions from theextending application, wherein the EHR-specific EHR adapter isconfigured to obtain the cross-EHR instructions and communicateconverted EHR-specific instructions to the browser extension, whereinsaid processor is configured to implement a functionality that is notprovided by the EHR system at least by: monitoring, by the browserextension, for an event in the EHR system; notifying, by the browserextension, the EHR-specific EHR adapter of the event via an EHR-specificinstruction; translating, by the EHR-specific EHR adapter, theEHR-specific instruction to a converted cross-EHR instruction that isprovided to the extending application via the runtime infrastructure;executing, by the extending application, a cross-EHR business logic inresponse to the converted cross-EHR instruction to determine a cross-EHRresponse; and translating, by the EHR-specific EHR adapter, thecross-EHR response to a converted EHR-specific instruction that can beimplemented by the browser extension over the EHR system.

THE BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

The present disclosed subject matter will be understood and appreciatedmore fully from the following detailed description taken in conjunctionwith the drawings in which corresponding or like numerals or charactersindicate corresponding or like components. Unless indicated otherwise,the drawings provide exemplary embodiments or aspects of the disclosureand do not limit the scope of the disclosure. In the drawings:

FIG. 1 illustrates a flowchart diagram of a method, in accordance withsome exemplary embodiments of the disclosed subject matter;

FIG. 2 illustrates a flowchart diagram of a method, in accordance withsome exemplary embodiments of the disclosed subject matter;

FIG. 3 shows a schematic illustration of an exemplary environment andarchitecture in which the disclosed subject matter may be utilized, inaccordance with some exemplary embodiments of the disclosed subjectmatter;

FIG. 4 shows a schematic illustration of an exemplary environment andarchitecture in which the disclosed subject matter may be utilized, inaccordance with some exemplary embodiments of the disclosed subjectmatter;

FIG. 5 shows a schematic illustration of an exemplary environment andarchitecture in which the disclosed subject matter may be utilized, inaccordance with some exemplary embodiments of the disclosed subjectmatter; and

FIG. 6 illustrates a block diagram of an apparatus, in accordance withsome exemplary embodiments of the disclosed subject matter.

DETAILED DESCRIPTION

One technical problem dealt with by the disclosed subject matter isenabling an extending service to extend a functionality or content of abrowsed page, e.g., by pushing additional content to the page, loadingresources thereto, or the like. In some exemplary embodiments, thebrowsed page may be associated with a data system that may retain datarecords of one or more users. In some exemplary embodiments, a pluralityof separate data systems may retain other records of overlapping users,e.g., with different or overlapping user information.

In some exemplary embodiments, the data systems may comprise, in somescenarios, Electronic Health Record (EHR) systems, and the browsed pagemay comprise a page of an EHR system. In some exemplary embodiments,EHRs, also referred to as Electronic Medical Records (EMRs), maycomprise records of medical data of a patient in a digital version. Insome exemplary embodiments, an EHR may contain the medical and treatmenthistories of patients, and may be accessed via various interfaces suchas EHR software systems which may comprise desktop applications,websites, or the like. In some exemplary embodiments, separate EHRsystems may retain data that is not synchronized with other EHR systems,data centers, or the like, such as regarding a same subject.

In some exemplary embodiments, EHR systems may be used by various actorsor entities such as a payer entity, a covered entity, a provider entity,a patient, or the like. In some exemplary embodiments, a payer maycomprise a health insurance entity, an entity that assumes the risk ofpaying for medical treatments, or the like. In some exemplaryembodiments, a provider may comprise doctors, Primary Care Physicians(PCPs), clinics, or the like, e.g., which may be supported by one ormore payers. In some exemplary embodiments, a covered entity maycomprise an entity who provides treatment, payment and operations inhealthcare such as a doctor's office, dental offices, clinics,psychologists, nursing homes, pharmacies, hospitals or home healthcareagencies, health plans, insurance companies, Health MaintenanceOrganizations (HMOs), or the like. In some exemplary embodiments,separate EHR systems may be used by different providers, differentpayers, different covered entities, or the like, each system thereof mayretain different data records of a same patient.

In some exemplary embodiments, EHR systems of any entity may retain adatabase or repository that comprises sensitive medical data, such asProtected health information (PHI). In some exemplary embodiments, PHIinformation may comprise data about a health status, provision of healthcare, payment for health care, or the like, that is created or collectedby a covered entity, and can be linked to a specific individual. In someexemplary embodiments, government regulations, privacy treaties, privacyconcerns, or the like, may impose one or more privacy restrictions onEHR systems. In some exemplary embodiments, EHR systems may be requiredto comply with government regulations or protocols, such as the FastHealthcare Interoperability Resources (FHIR) standard created by theHealth Level Seven International (HL7) health-care standardsorganization, which comprises a permitted Application ProgrammingInterface (API) for exchanging EHR records. In some exemplaryembodiments, government regulations, as well as privacy concerns, mayprohibit unrelated parties from accessing PHI information of a patient,such as a patient's medical record or payment history. In some exemplaryembodiments, this may prevent an EHR system that is used on behalf of apatient from accessing data of the same patient that is retained in aseparate EHR system, even if such information is crucial for providingmedical care to the patient. Additionally, as EHR systems may comprisesensitive and protected data, which may limit data sharing protocols.

In some exemplary embodiments, EHR systems that do not share with eachother data about a shared patient may have one or more drawbacks for thepatient. For example, in case an EHR system of a patient's payer and anEHR system of the patient's provider are prevented from sharing thepatient's data, or do not share such data for any other reason, theprovider may not know about the history, conditions, or the like, of thepatient, which may be determined by the payer. As another example, incase separate EHR systems that retain data records of the patient areprevented from sharing the patient's data with each other, the user mayuse a first EHR system without having access to medical recommendationsfrom the second EHR system, the user may be provided with an incorrectdiagnosis at the first EHR system as the relevant medical informationmay be retained at the second EHR system, or the like, e.g., which maybe life threatening in some cases. In some exemplary embodiments,prohibiting EHR systems from sharing with each other data about a sharedpatient may have one or more drawbacks for the payer, as the payer maynot have sufficient information to estimate an overall medical state ofthe patient. It may be desired to correlate user information overdifferent EHR systems, without violating any privacy regulations orconcerns.

In some exemplary embodiments, it may be desired to provide an extendingservice for extending a Graphical User Interface (UI) (GUI) of an EHRsystem with extending applications such as additional data,functionalities, or the like, that are not available in the EHR systembut can be obtained or derived from different EHR systems. For example,it may be desired to push additional content to a browsed EHR page, loadresources thereto, or the like.

A naïve solution for loading extending applications over an EHR systemmay include modifying the EHR system to include the extendingapplications within the system. The naïve solution may have one or moredrawbacks. In some exemplary embodiments, modifying each EHR systemseparately, may not be scalable when dealing with a large number of EHRsystems, e.g., hundreds of EHR systems. In some exemplary embodiments,modifying all of the EHR systems independently may be resourceconsuming, time consuming, or the like.

A second naïve solution to the drawbacks of modifying each EHR systemindependently, may include utilizing dynamic loading of code to loadextending applications. In some exemplary embodiments, a client-sideagent may be configured to dynamically load code of a functionality thatis to be augmented to an EHR system, by fetching the code from a backendserver and activating the code. In some exemplary embodiments, thissolution may overcome the drawbacks of modifying each EHR systemindependently, at least since dynamic loading of code can be cross-EHR,and may be performed for multiple EHR systems. For example, the code ofthe functionality may be obtained in the form of a string, and the codemay be activated such as by using an “eval” JavaScript command toexecute the string, or by using any other activating command. The secondnaïve solution for dynamically loading code of a functionality may haveone or more drawbacks. In some exemplary embodiments, fetching andactivating code may introduce the risk that the code might bemanipulated by an adversary, which may damage the hosting EHR systemover which the code is executed, may damage a backend thereof, maydamage the augmenting entity that fetches and activates the code, or thelike.

Another technical problem dealt with by the disclosed subject matter isenabling an extending service to augment functionalities over multipledata systems, e.g., in a secure manner, while overcoming the drawbacksof the naïve solution.

Yet another technical problem dealt with by the disclosed subject matteris to provide users with a smooth and seamless integration of augmentedapplications with the EHR system that is being used, while enabling theextending applications to push valuable content on to a user's workflow.For example, it may be desired that the extending service will beenabled to monitor the browsed page and provide an extending applicationsuch as recommendations of doctors that are being searched for, withoutadversely affecting the user's workflow in the EHR system.

Yet another technical problem dealt with by the disclosed subject matteris enabling third party unauthorized entities, that are not authorizedto access sensitive data, to provide an augmented functionality that isintended to be executed over the EHR systems in certain scenarios,without exposing any sensitive data of users to the unauthorizedentities. For example, a third party entity may desire to providerecommendations of a list of providers that are covered by a payer ofthe user, without being exposed to the list or to any PHI information.

Yet another technical problem dealt with by the disclosed subject matteris executing an extending application over the EHR system and enablingit to push content to a browsed EHR page, load resources thereto, or thelike, in case the content that is added to the browsed EHR page isallowed to be exposed to the user consuming the browsed EHR page, andwithout exposing sensitive user data to unauthorized entities.

It is noted that the disclosed subject matter is exemplified withrelation to different EHR systems that do not share data, but it is notlimited to the medical realm or to EHR systems specifically. As anexample, the disclosed subject matter may be applied to any otherdata-retaining systems. In some exemplary embodiments, the EHR systemsthat are described herein may comprise any software systems that retainrecords of data of a same subject without being enabled or configured todirectly share the data with each other. For example, the systems maycomprise two separate systems for retaining résumés, both retaining arésumé of a same applicant without enabling each other to share herretained résumé. Alternatively, the data that is retained at the systemsmay not relate to a human subject but to any other subject, object,topic, or the like.

One technical solution provided by the disclosed subject matter isproviding an architecture comprising a software agent such as a browserextension and runtime infrastructure that are associated with anextending service, provided thereby, or the like. In some exemplaryembodiments, the extending service may be configured to accumulateEHR-related data from multiple EHR systems over which extendingapplications may be executed, such as payer systems, provider systems,covered systems, or the like. The extending service may retain a storageof data records at a server or any other computing device that isindependent from the EHR systems, from the payer systems, from theprovider systems, or the like. In some exemplary embodiments, thestorage of the extending service may retain user accounts, user records,data records from payer and provider entities, data regarding providers,data regarding covered entities, data regarding payers, accumulate datafrom interfaces of EHR systems, or the like, which may enable extendingapplications to augment new functionalities over EHR systems.

In some exemplary embodiments, the extending service may be configuredto execute one or more extending applications over EHR systems that arebeing used by a patient or on behalf of the patient. For example, uponlogging in to an EHR system, the extending service may automaticallyidentify the logging in process of the patient, scrape her credentials,and log the user into her account of the extending service, which may beindependent from the EHR system, and execute one or more extendingapplications over the EHR pages that are browsed by the user. In someexemplary embodiments, an extending application of the extending servicemay be configured to push additional content to an EHR page, loadresources thereto, manipulate GUI elements, provide data orfunctionalities to the EHR page, or the like. In some exemplaryembodiments, the storage of the extending service may enable a userbrowsing an EHR session to utilize functionalities that are derived fromdifferent systems such as a payer entity, a provider entity, a coveredentity, a separate EHR system of a same type of entity, a combinationthereof, or the like.

In some exemplary embodiments, the extending service may distribute oneor more software agents to local memories of user devices, providercomputers, payer systems, or the like. In some exemplary embodiments, anagent may comprise a software module such as a browser extension, whichmay be executed by a browser rendering the EHR system. Alternatively, anagent may comprise a software module such as a Software Development Kit(SDK) or Dynamic-Link Library (DLL) files in the disk memory that may beexecuted over a desktop EHR system. In some exemplary embodiments, incase of a desktop agent, the agent may be located or retained in EHRexecutables of the of the desktop EHR system, in Operating System (OS)executables, adjacently to the installation or address of the associatedEHR system, or the like. In some exemplary embodiments, in case the EHRexecutables of the of the desktop EHR system are located in a virtualmachine, a desktop designated agent may be deployed in the virtualmachine, from which the agent may receive updates regarding the EHRsystem.

In some exemplary embodiments, an agent may be utilized to monitor theuser interface of the EHR system, the Document Object Model (DOM)thereof, hooks thereof, events thereof, or the like, and to dynamicallyload one or more extending applications over the executing EHR system.In some exemplary embodiments, the extending applications may beconfigured to provide additive functionalities, data, a combinationthereof, or the like, that may be added to or embedded in the EHR pageof the EHR system. For example, an extending application may beconfigured to add or manipulate a GUI element in the page, such as inorder to enable the user to perform a functionality such as booking atreatment that was not enabled prior to executing the extendingapplication.

In some exemplary embodiments, an agent (also referred to as the“extension”) may be configured to conduct communications with thebackend of the extending service, e.g., to obtain an EHR adapter to anunderlying EHR system that is being used by the user, to obtainextending applications therefrom, to enhance a security of a usersession, or the like. In some exemplary embodiments, the agent may beconfigured to augment EHR systems with one or more extendingapplications comprising software layers that can be executed over theEHR system. In some exemplary embodiments, the extending applicationsmay be loaded in one or more Inline Frames (iframes) that may be managedby the EHR adapter. In some exemplary embodiments, prior to augmentingEHR systems with one or more extending applications, the agent mayverify that a domain of the underlying system comprises a domain forwhich the agent is configured, e.g., a domain of an EHR system. Forexample, the agent may retain a list of domains of EHR systems, andcompare the domains to a domain of a rendered page, prior to attemptingto augment an extending application thereover.

In some exemplary embodiments, the agent may be configured to monitor anEHR display of the user, such as in response to an instruction of an EHRadapter that is loaded over the page, and accumulate informationtherefrom, which may or may not be added to a storage in the backend ofthe extending service. In some exemplary embodiments, the agent mayprovide facilities for an extending application to provide itsfunctionality over the display of the user, such as by injecting iframesthat enable extending applications to be loaded therein, retrievingextending applications from the server such as based on the monitoreddisplay of the user, or the like. In some exemplary embodiments, theextending application may utilize the agent's facilities, such as theiframe, in order to load functionalities from the backend of theextending service. In some exemplary embodiments, the browser extensionmay be configured to monitor the user's display, monitor the EHR userinterface, track cursor and keyboard activity, or the like, and identifybrowser events. In some exemplary embodiments, the extension may beconfigured to access a DOM or any other representation of the browsedEHR pages such as via hooks, API calls, or the like, and communicatewith the EHR adapter therein. In some exemplary embodiments, theextension may obtain event data or page data by monitoring the page,subscribing to events within the page, monitoring network traffic, usingWindows™ API calls or any other API calls, performing dynamic injectionof DLLs, or the like. In some exemplary embodiments, the extension maybe configured to inform one or more iframes of any detected browserevents.

In some exemplary embodiments, the extending applications may beconfigured to push content and resources over a page, and may be loadedin iframes that may be generated or injected by the browser extension oranother monitoring agent that is executed at the client-side. Theextending applications may provide the user with additional medicaloptions, additional medical data, additional semi-medical data, or thelike. In some cases, extending applications may be configured to inserta widget into the DOM, manipulate a widget, re-launch a window, or thelike. In some exemplary embodiments, an extending application maycomprise an automation code such as a Robotic Process Automation (RPA)embedded within an iframe that is not visible, has no GUI, or the like,while the code may automatically interact with the EHR system and modifyproperties thereof, change its behavior, or the like. For example, anautomation code may be configured to enable the user to book a treatmentat a provider that is not available via the EHR system, which may beactivated from a remote backend.

The extending applications may comprise cross-EHR applications that arenot specifically tailored for a specific EHR system, but are ratherconfigured to be executed over various different EHR systems that arenot related or associated with each other or with the extending service,that are not enabled to access each other, that belong to differententities, or the like. The extending applications may enable to indicateto a first active EHR system, medical information or functionalitiesthat are derived from a second EHR system to which the first EHR systemhas no access, that are derived from a server of a payer to which thefirst EHR system has no access, that are derived from a server of acovered entity to which the first EHR system has no access, or the like.The medical information or functionalities that is indicated to thefirst EHR system may only include data to which the first EHR system haspermission to access, is authorized to access, or the like. In somecases, an extending application loaded in an iframe may enable separateEHR systems to share data with each other indirectly, possiblyunintentionally, and to provide augmented applications that can enrichthe medical options, augment the EHR system's display with additionaldata, or the like, thereby enhancing a workflow of the user. In someexemplary embodiments, the augmented applications may comprise, forexample, recommendations of providers that are supported by the payer,scores of doctors based on selected parameters such as cost and quality,scores that are obtained from the payer's system, scores of doctorsbased on processing data at the extending service, or the like.

In some exemplary embodiments, the EHR adapter may obtain from a backendserver a list of one or more applications for which the user haspermission to access, that are relevant to the current EHR session, orthe like. In some exemplary embodiments, the EHR adapter may load thelisted applications in one or more respective iframes that may bedynamically injected to the page by the extension, e.g., in response toan instruction from the EHR adapter, in response to an instruction fromthe backend server, or the like. Alternatively, the extendingapplications may be loaded in any other widget, GUI element, structure,or the like. In some exemplary embodiments, the iframes may not haveaccess to the DOM of the EHR page, and may therefor rely on the EHRadapter to identify events of interest. In some exemplary embodiments,instead of accessing the DOM, the iframes may obtain page properties andevents via the extension, which may provide indications of such eventsto the EHR adapter. In some exemplary embodiments, the EHR adapter mayenable to load the iframes with respective resources, and may enable toadd, modify or remove iframes.

In some cases, an injected iframe may load an extending application byembedding a document, e.g., a HyperText Markup Language (HTML) documentassociated with the storage of the extending service within the browsedpage of the currently used EHR system, by embedding a GUI elementtherein, by embedding executable code therein, or by comprising anyother resource. In some exemplary embodiments, the iframe may provide anextending application by executing a Uniform Resource Locator (URL) linkembedded in the iframe, or any other link that is associated to theiframe, embedded therein, pointed by the iframe, or the like.

In some exemplary embodiments, an iframe may load itself with extendingapplications from the platform of the extending service, or from anyother server, such as by executing a linked URL that is linked to anextending application, thereby loading the extending application overthe EHR system and presenting the user with augmented data andfunctionality. In some exemplary embodiments, an iframe that is injectedin the page may be enabled to communicate with both the backend of theextending service, and executing infrastructure such as the EHR adapter.For example, an iframe may communicate with the EHR adapter usinginter-browser communications such as postMessage communications, and theiframe may communicate with the storage using Hypertext TransferProtocol (HTTP) communications.

In some exemplary embodiments, the extension may be configured to informiframes loading extending applications about occurring page events viaruntime infrastructure. In some exemplary embodiments, the extension maybe configured to update or inform the EHR adapter about the occurringevents, and the EHR adapter may be configured to convert or translateevent data to a cross-EHR and cross-application format, e.g., which maycorrespond to a format used by the applications. In some exemplaryembodiments, as each EHR system may retain, in its backend server, datarecords in various uncorrelated formats, code languages, variable names,or the like, the EHR adapter may be configured to translate or convert aformat of a specific EHR system to a cross-EHR format including a singlerepresentation of ongoing events and data that may be used for all ofthe extending applications. Determining a cross-EHR representation maybe performed manually, such as by manually providing or obtaining adifferent conversion implementations for each EHR adapter, orautomatically, such as by using computer vision techniques, automaticclassifiers, data science modules configured to inspect the content ofthe page, text recognition methods, image recognition methods,monitoring network traffic, using Windows™ API calls or any other APIcalls, performing dynamic injection of DLLs, or the like, to obtain datain different versions and convert the data to the cross-EHR version. Theconversion may be performed by the EHR adapter for one or more EHRsystems, such as for EHR systems of certain clinics, payers, providers,covered entities, or the like. In some exemplary embodiments, each typeof EHR system may be allocated an EHR adapter that is enabled to convertor translate the data from the EHR systems to a unified cross-EHRformat. In some cases, the cross-EHR format may be generated to comprisea non-sensitive form, such as a form that does not comprise PHIinformation, Personally Identifiable Information (PID information, orthe like. For example, the EHR adapter may convert event data to acommon event pattern or description that does not include the name ofthe patient, an identifier of the patient, a timestamp of the event, orthe like. In other cases, the cross-EHR format may comprise a sensitiveform, which may comprise PHI information, PII information, or the like,in a unified cross-EHR format. In some exemplary embodiments, the EHRadapter may provide the cross-EHR version of the events to the runtimeinfrastructure, which may be configured to inform the extendingapplications loaded in the iframes of the events.

In some exemplary embodiments, the runtime infrastructure may beutilized to dynamically load code, e.g., of one or more extendingapplications, over the EHR system, such as by loading the iframes withrespective URLs. In some exemplary embodiments, the runtimeinfrastructure may enable to adjust the extending applications that areloaded in the iframes by adding, modifying or removing URLs from theiframes, and reloading the iframes. In some exemplary embodiments, theruntime infrastructure may dynamically adjust or modify one or moreextending applications that are loaded in iframes, such as by modifyingtheir URLs and reloading the iframes, modifying their link to resourcesand reloading the iframes, modifying a code of the resources to which aURL points, modifying resources to which a URL points, or the like. Forexample, the user may wish to book a physician office visit with aprovider that is supported by her payer. However, the EHR system that isused by the user may provide a list of physicians according to thealphabetical order, which may not indicate which physicians are morerecommended, have better results, are cheaper, are available in relevanttimes, or the like. In such a case, the runtime infrastructure may loadan extending application over an iframe, or activate the extendingapplication, in order to provide an augmented list that are listedaccording to a desired rating, e.g., a list of physicians that aresupported by the user's payer, physicians listed according to ratingsfrom multiple users, physicians listed according to historic lengths ofthe overall treatment, physicians listed according to historic results,physicians listed according to historic treatments analysis, physicianslisted according to a rating determined by the extending service, thediagnosis of the patient, the desired procedures, the specialty of thephysicians, a distance of the physicians from the patient's home, adistance of the physicians from the patient's work, or the like. Forexample, the historic treatments analysis may indicate that a providerthat is declared as orthopedist has historically performed dozens ofknee surgeries, thereby indicating that she can be listed as a kneespecialist. In some cases, in case the extending application may nothave an available iframe on which it can be loaded, the runtimeinfrastructure may instruct the extension to inject an iframe into thepage, and then load the extending application therein.

In some exemplary embodiments, the functionality of the extendingapplications may change dynamically, during the execution time of theextending application, without requiring modifying in any way theextension or the runtime infrastructure, thus complying with one or moreprivacy regulations such as GOOGLE™ restrictions. In some exemplaryembodiments, while iframes may be dynamically loaded in runtime, theextension may remain constant, with a constant code, structure, SDK, orthe like, without being dynamically loaded. In some exemplaryembodiments, iframes may be adjusted by the runtime infrastructure topoint to a different application. For example, an extending applicationmay be loaded in an iframe, and adjusted to point to a new applicationor application version in runtime, such as in response to real timeevents that are monitored by the extension, after which the newapplication or version may be reloaded and executed in the iframeinstead of the previous application. According to this example, newversions and applications are re-loaded without requiring anyinstallation or modification of assets or code at a client side. In somecases, the runtime infrastructure, the EHR adapter, or the like, may beloaded in respective visible or invisible iframes, and adjusted inruntime, such as in response to real time events that are monitored bythe extension.

Another technical solution provided by the disclosed subject matter isproviding a platform for cross-entity applications. In some exemplaryembodiments, a platform comprising the extension, the runtimeinfrastructure, the EHR adapter, and the extending service may beutilized to enable multiple entities or vendors that may or may not beauthorized to handle PHI data of patients to generate or createextending applications for EHR systems. For example, the disclosedplatform may be used as a marketplace of extending applications,enabling users to obtain or install extending applications that theydesire for their EHR systems, without compromising on their privacy.According to this example, the marketplace may comprise only client-sideapplications that are available in the marketplace, which may be handledby the disclosed platform without enabling the applications to replaceportions of the platform.

In some exemplary embodiments, unauthorized extending applications fromunauthorized entities may not be enabled to communicate directly withthe backend of the extending service, as its storage may comprisesensitive data. Alternatively, the unauthorized extending applicationsmay be enabled to communicate directly with the backend of the extendingservice, but the extending service may identify that the applicationsare unauthorized and avoid from providing sensitive data thereto. Insome exemplary embodiments, the unauthorized extending applications mayinterface and interact only with the runtime infrastructure, which mayindicate thereto a cross-EHR cross-application events in a non-sensitiveversion, in case the applications are registered thereto, and obtaintherefrom a responsive action or instruction. In some exemplaryembodiments, the platform may control any data that is provided toapplications and implementation of responsive actions.

In some exemplary embodiments, since the EHR adapter may convert realtime EHR events to cross-EHR events, which may be forwarded to theruntime infrastructure and indicated only to registered applicationsthat are registered to such events, the unauthorized third party serverof the unauthorized application may not have access to sensitive eventdata of the user. Instead, the unauthorized provider or server maymerely be enabled to provide an application that can generate aresponsive command or action in response to certain cross-EHR events,without necessarily obtaining at the server an indication that the eventoccurred, that a response to the event was instructed, or without havingany indications of event properties beyond the mere occurrence of theevent.

In some exemplary embodiments, the cross-EHR representation of eventsmay create an abstraction layer over EHR APIs, e.g., in order to preventthe third party applications from accessing the EHR systems, as they maybe exposed to cross-EHR events and data only. In some exemplaryembodiments, the abstraction layer may enable the various entities towrite and generate custom business logic for a cross-EHR applicationthat is configured to use the abstraction layer without being aware ofthe EHR vendor, without communicating therewith, or the like. In someexemplary embodiments, any third party entity or vendor may be enabledto register or provide extending applications to the platform, withoutexposing the EHR internals to the third party entity, and withoutrequiring the vendor to specify the code of the application toproperties of a specific EHR system.

In some exemplary embodiments, the architecture of the platform maycontain an agent such as the browser extension, a computer vision basedagent, a digital signal extraction agent, or the like, which may beresponsible for low level interactions with the EHR system, e.g.,monitoring EHR events and data. In some cases, in addition to or insteadof the browser extension, such as in the case of an EHR system thatcomprises a desktop EHR system that is not rendered by a browser, theagent may comprise one or more alternative agents such as a computervision based agent, a digital signal extraction agent, a Windows™ API(WinAPI) agent, a sniffer, or the like. In some exemplary embodiments,the agent may comprise a computer vision-based agent that may be enabledto monitor and identify events of the EHR system using one or morecomputer vision techniques, classifiers, identifiers, or the like. Insome exemplary embodiments, computer vision techniques may enable toextract and identify content, and EHR events such as cursor activities,keyboard activities, or the like, from a displayed screen of an enddevice. In some exemplary embodiments, the agent may comprise a digitalsignal extraction agent comprising a binary that may be linked orinjected into the EHR code, enabling to monitor the activity of the EHRsystem in runtime. In some exemplary embodiments, the agent may comprisea sniffer that may be utilized to monitor events issued by the EHR code.In some exemplary embodiments, the agent may comprise a reverseengineering module that may be utilized to monitor events using one ormore reverse engineering techniques. In some exemplary embodiments, theagent may comprise a virtual machine that runs the EHR code and may beutilized to monitor events. Alternatively, EHR events may be monitoredusing an accessibility toolkit of the underlying Operating System (OS),e.g., using an OS provided screen reader, an OS provided eventidentifier, or the like.

In some exemplary embodiments, the architecture of the platform maycontain EHR adapters for respective EHR systems, which may correspond tothe runtime infrastructure. In some exemplary embodiments, the EHRadapters may communicate with the agent, obtain events therefrom,convert them to a cross-EHR form, and provide them to registeredapplications. In some exemplary embodiments, an EHR adapter for aspecific EHR system may be responsible for monitoring or processingevents of the EHR system that are obtained from the agent's API, andconverting the events into a cross-EHR structure or format. In someexemplary embodiments, the EHR adapter may be embedded in the DOM of theEHR page, e.g., in an iframe, but may not be visible from a UIperspective, in contrast to cross-entity applications loaded in iframesthat in some cases may be visible as part of the UI, the DOM, or thelike.

The EHR adapter may be loosely coupled with a DOM of a specific EHRsystem, as, in order to enable conversion of event formats from an EHRsystem to cross-EHR representations, an adapter may be configured tomatch a format of a specific DOM of an EHR system. In some exemplaryembodiments, an EHR-specific event or instruction may refer to aninstruction that is represented in a manner that matches the syntax,format, form, language, API calls, code mapping, or the like, of aspecific EHR system, and not necessarily to other EHR systems. In someexemplary embodiments, a cross-EHR instruction or event may refer to aninstruction that is represented in the same manner for all or multipleEHR systems, and at all or multiple extending applications. A samecross-EHR representation of events, instructions, or the like, may beused by multiple applications for multiple EHR systems. In someexemplary embodiments, registered extending applications may beconfigured to communicate with the runtime infrastructure of thedisclosed platform using a cross-EHR form of events. In some cases, asame adapter may be used for two or more EHR systems, e.g., similar EHRsystems with different owners.

In some exemplary embodiments, the runtime infrastructure may indicateevents to registered applications using a cross-EHR form of the events.In some exemplary embodiments, upon obtaining an indication of aregistered event, registered applications may respond with cross-EHRinstructions, which may be converted to an EHR-specific form by theruntime infrastructure. In some exemplary embodiments, the runtimeinfrastructure may convert the commands to the EHR-specific orclinic-specific API calls, which may be implemented by an agent such asthe browser extension. For example, an instruction from an applicationmay comprise a general form of an API call, and the runtimeinfrastructure may convert the instruction to an EHR-specific API callthat matches the underlying EHR system. As another example, aninstruction from an application may comprise a general form of a code,and the runtime infrastructure may convert the instruction to anEHR-specific code that matches the underlying EHR system and can beexecuted by the agent over the EHR system. Additionally oralternatively, the runtime infrastructure may invoke an automatedprocess for extracting requested information without the use of an API,such as using computer vision techniques, using a sniffer process,scraping information from the memory, or the like.

One technical effect of utilizing the disclosed subject matter iscreating a smooth and seamless integration of an extending applicationwith the underlying EHR system, without having access to source code ofthe EHR system, while enabling the extending application to pushvaluable content to a user's workflow in an intuitive seamless manner.In some exemplary embodiments, based on a backend storage integratingmultiple data sources that are associated with the patient, an extendingapplication may be enabled to provide additional useful data,functionalities, or the like, that are not offered by the underlying EHRsystem. Utilizing the extending service may enable to eliminatechallenges of ingesting, processing, storing, and utilizing healthcaredata, by providing an extending application that is loaded over theworkflow and provides missing or additional data, functionality, or thelike. The extending application may be executed over multiple EHRs,payer systems, provider systems, or the like.

Another technical effect of utilizing the disclosed subject matter isenabling to utilize patient records and related data from variousseparated systems, e.g., EHR

MW Ref GLAP 11969A

GA Ref 752-1.1 systems, to generate extending applications which mayenable the patient or a caretaker of the patient to locate treatmentsgaps of the patient, to diagnose the patient in a more informed oraccurate manner, to inform the patient with provider options that aremade available to her by her payer, to inform the patient of additionalinformation regarding the provider options, or the like.

Yet another technical effect of utilizing the disclosed subject matteris creating a constant API on top of the EHR system, which may enableextending applications to access, modify, and receive updates from theEHR system and act thereon. In some exemplary embodiments, thisarchitecture enables dynamic functionality improvements over EHRsystems, without exposing the EHR system to the risks of dynamic codeupdates, and with a minimum footprint on the underlying EHR systems. Insome exemplary embodiments, utilizing the extension enables dynamicfunctionality improvements.

Yet another technical effect of utilizing the disclosed subject matteris enabling an extending service to dynamically load extendingapplications over a web-based EHR system, a desktop-based EHR system, orany other iframe-supporting system without deployment of the extendingservice on the edge station, such as by using a browser extension thatcan be used for adding new functionalities in real time, for adjustingfunctionalities in real time, or the like, without requiring to update aversion of the extension per new functionality. In some exemplaryembodiments, in some cases, the agent may require edge stationinstallation, such as in order to install a browser extension, aWindows™ agent, or the like.

Yet another technical effect of utilizing the disclosed subject matteris enabling extending applications to access, modify, and receiveupdates from various EHR systems including web-based EHR systems, EHRwebsites, desktop-based EHR systems, or the like. The agent may comprisea browser extension in the case of EHR websites, or a desktop agent inthe case of desktop-based EHR systems that are retained at the enddevice such as at the desktop thereof.

Yet another technical effect of utilizing the disclosed subject matteris providing a platform that enables entities to generate a singleapplication for multiple EHR systems, without having access tounauthorized data. In some exemplary embodiments, the EHR adapter of theplatform may convert the EHR events to a standard representations ineach EHR system for which the adapter is configured, without theapplication provider being required to perform any adaptations oradjustments to specific EHR systems. Using the API of the EHR may enablevarious application providers to provide a multi EHR application totheir clients, that do not have access to the storage of the extendingservice. In some exemplary embodiments, having a single application formultiple EHR systems, instead of utilizing a different application foreach EHR system, may save developing time, memory storage, executiontime, or the like.

The disclosed subject matter may provide for one or more technicalimprovements over any pre-existing technique and any technique that haspreviously become routine or conventional in the art. Additionaltechnical problem, solution and effects may be apparent to a person ofordinary skill in the art in view of the present disclosure.

Referring now to FIG. 1 illustrating a flowchart diagram of a method, inaccordance with some exemplary embodiments of the disclosed subjectmatter.

In some exemplary embodiments, a software agent may be configured tomonitor for one or more events in an underlying EHR system. In someexemplary embodiments, the software agent may be configured to monitorand interact with a DOM of a page of an underlying EHR system. In someexemplary embodiments, the software agent may comprise a browserextension that may be executed by a browser. In such a case, the browsermay be configured to render the page of the EHR system. In someexemplary embodiments, the software agent may comprise a desktop agent,and the EHR system may comprise a desktop-based EHR system that is notexecuted in a browser. In such a case, the desktop agent may beconfigured to be executed over the desktop-based EHR system.

In some exemplary embodiments, in case the agent comprises a browserextension, the browser extension may be composed of a one or moreportions, scripts of the like, such as a background script and a contentscript. In some exemplary embodiments, the background script may enablethe extension to interaction with the API of the browser such as forstorage purposes, in order to open a new tab of the browser, in order tosend a request to a third party such as a backend of the extendingservice, with a database of the extending service, or the like. In someexemplary embodiments, the background script may not have access to theDOM of the browsed page. In some exemplary embodiments, the contentscript may enable the extension to access the DOM of the EHR website,the EHR web application, the EHR desktop application, or the like. Insome exemplary embodiments, as the content script may have access to theDOM of the browsed page, the content script may handle the interface ofthe user such as by modifying the interface, injecting iframes into theinterface, accumulating data therefrom, or the like.

In some exemplary embodiments, the following steps may be performed inorder to implement one or more augmented functionalities that are notprovided by an underlying EHR system.

On Step 110, the software agent may load, dynamically, a runtimeinfrastructure in a first iframe that may be embedded in the page of theEHR system. In some exemplary embodiments, the agent may load anEHR-specific EHR adapter that may be specifically designed or tailoredbased on the EHR system, e.g., to match the syntax, format or structureof the EHR system, over the page. In some exemplary embodiments, theruntime infrastructure may lack a GUI representation, such as bycomprising an invisible iframe that does not embed a visible resourcesuch as a visible GUI element, a visible document, or the like, whichmay not be perceivable in a display of a user device. Alternatively, theruntime infrastructure may comprise a visible GUI.

In some exemplary embodiments, the software agent may be configured toinject the first iframe in the page of the EHR system and cause theruntime infrastructure to be loaded into the first iframe. In someexemplary embodiments, the software agent may inject the first iframeinto the page or the DOM of the EHR system, e.g., upon obtaining runtimeinfrastructure that matches the specific EHR system that is being usedfrom the backend of the extending service, upon obtaining a list ofrelevant extending applications from the backend, or the like.

On Step 120, the runtime infrastructure may be configured to load,dynamically, one or more extending applications in respective secondiframes that may be embedded in the page of the EHR system. In someexemplary embodiments, the software agent may be configured to injectthe second iframes in the page of the EHR system and enable the runtimeinfrastructure to load an extending application into a second iframe. Insome exemplary embodiments, the runtime infrastructure may be configuredto dynamically load the extending application in the second iframe byprovisioning a URL of the extending application to be loaded in thesecond iframe. In some exemplary embodiments, the URL may point to acode of the extending application, a source thereof, or the like.

In some exemplary embodiments, the list of applications to be loaded maybe available in a marketplace, which may enable any provider to upload anew application to the marketplace, and may enable any user to installany desired application from the marketplace. In some exemplaryembodiments, the runtime infrastructure may be configured to retrievefrom a server of the extending service a list of extending applicationsto be loaded in the page, e.g., extending applications that are ofinterest to the user (e.g., were installed by the user, match thecontext of the page, or the like) and the user has permission to accesstheir functionality in the current context of the page. In someexemplary embodiments, the list of applications to be loaded may bedetermined based on access permissions of a user of the EHR system toapplications in an application repository, e.g., in a backend of theextending service.

In some exemplary embodiments, the list of applications to be loaded maycomprise a first extending application that is loaded within the secondiframe and a second extending application that is loaded within a thirdiframe, each belonging to a different organization associated with adifferent server. For example, the first extending application may beobtained from a first server that belongs to a first organization,client, EHR system, payer, provider, partner, or the like, and thesecond extending application may be obtained from a second server thatbelongs to a second organization, client, EHR system, payer, provider,partner, or the like. In some exemplary embodiments, the runtimeinfrastructure may be configured to dynamically load the secondapplication in response to an event monitored by the agent, or based onany other calculation or identification. In some exemplary embodiments,the runtime infrastructure may be configured to dynamically load thesecond application within an existing iframe, within a new iframe, orthe like. In some exemplary embodiments, the runtime infrastructure maybe configured to dynamically load the second application in anadditional, e.g., third, iframe embedded in the page, such as byprovisioning a URL to be loaded in the third iframe. In some exemplaryembodiments, the third iframe may be injected in the page by thesoftware agent, e.g., prior to or after identifying the event, and theURL may point to a code of the second application, such that anymodification of the code may affect the execution of the URL in thethird iframe. In some exemplary embodiments, the runtime infrastructuremay be configured to dynamically load the second application in anexisting iframe, e.g., the second iframe, which may be occupied with adifferent URL. The second application may be loaded into the secondiframe by provisioning a URL of the second application to be loaded inthe second iframe, thereby changing the URL of the first applicationwith a URL of the second application within the same iframe. In someexemplary embodiments, the URL of the second application may beconfigured to point to a code of the second application, therebyreplacing or adjusting a URL of the first application and enabling todynamically load the second application in the second iframe. In somecases, the second application may comprise an updated version of thefirst application, a separate application from a different vendor, orthe like.

In some exemplary embodiments, an extending application may comprise aGUI component that may be visible, e.g., including a visible resource, avisible UI widget, a visible embedded document, or the like. In someexemplary embodiments, an extending application may comprise a resourceor code that is not visible, has no GUI component, or the like, e.g., anautomation process. In some exemplary embodiments, the extendingapplications may each retain business logic that may be configured tomanipulate the GUI component, perform a data presentation, loadresources over the EHR page, or the like, in order to enable anadditional functionality to be loaded over the page.

In some exemplary embodiments, an extending application may comprise anaugmented or added functionality that is configured to be loaded in arespective iframe embedded in the page. In some exemplary embodiments,the functionality may be absent in the page of the EHR system, absent inthe EHR system, may not be served by the EHR interface, or the like. Insome exemplary embodiments, the functionality may be determined to beabsent from the EHR system, e.g., by the runtime infrastructure, an EHRadapter, the software agent, or the like. For example, an extendingapplication may be configured to load a resource that is associated witha user of an end device executing the software agent, that can beaugmented to the workflow of the user, or the like. As another example,the extending application may comprise manipulating a GUI element suchas a button associated with the extending service.

In some cases, the extending application may comprise an automationprocess or code that may be executed in an iframe loading the extendingapplication, e.g., an invisible iframe lacking a GUI representation. Insome exemplary embodiments, the automation process may not comprise avisual resource but rather an automation process that can be executed inthe iframe and cause other portions of the GUI to be modified. In someexemplary embodiments, the automation code may be activated remotelysuch as by a remote server of an extending service, or locally such asby the software agent. For example, an automation process may beconfigured to imitate a user interaction with the user interface of theEHR system. As another example, the automation code may be configured toload from the backend server of the extending service a list ofproviders that match the user, which may be loaded by executing the codeof the automation process.

On Step 130, the software agent may be configured to communicate eventsand responsive actions with the EHR adapter. In some exemplaryembodiments, the agent may be configured to provide one or more firstEHR-specific data, events, instructions, or the like, such as regardingidentified events, to the EHR adapter. In some exemplary embodiments,the agent may be configured to provide the EHR-specific data in responseto an instruction of the EHR adapter. For example, the EHR adapter mayinstruct the agent to monitor a component or element of interest. Insome exemplary embodiments, the EHR adapter may be configured to receivethe first EHR-specific data from the software agent, and translate thefirst EHR-specific data to first cross-EHR data or instructions, whichmay not be EHR-specific in their syntax, format, or the like, but rathermay be used for any application in any EHR system. In some exemplaryembodiments, the EHR adapter may communicate the first cross-EHR data tothe runtime infrastructure, which may communicate the first cross-EHRdata to extending applications that are registered to the event.

In some exemplary embodiments, the extending applications may beconfigured to instruct the EHR adapter to perform responsive actions inresponse to the monitored events, such as to augment data, load content,load resources, load applications, execute functions, modify GUIelements, or the like, over the page of the EHR system. In someexemplary embodiments, the EHR adapter may be configured to receivesecond cross-EHR instructions from the extending applications, such asregarding a responsive action to an event, and translate the secondcross-EHR instructions to second EHR-specific instructions, which may beEHR-specific in their syntax, format, or the like. In some exemplaryembodiments, the EHR adapter may communicate the second EHR-specificinstructions to the software agent, such as in a form that specificallymatches the underlying EHR system.

In some exemplary embodiments, the software agent may identify ormonitor an event in the EHR system. For example, the event may compriseidentifying a user-initiated search of a provider in the EHR system. Insome exemplary embodiments, the software agent may notify the EHRadapter of the event, such as via an EHR-specific instruction thatmatches the underlying EHR system. In some exemplary embodiments, priorto notifying the EHR adapter of the event, the software agent maydetermine whether the event corresponds to a defined list of events,e.g., a whitelist of events, events that are permitted to be forwardedto the EHR adapter, events that are relevant to the EHR system, or thelike. In some exemplary embodiments, in case the event corresponds tothe defined list of events, the software agent may provide an indicationof the event to the EHR adapter.

In some exemplary embodiments, in response to the event indication, theEHR adapter may communicate with registered applications, e.g.,according to the steps of FIG. 2. In some exemplary embodiments, the EHRadapter may obtain from the registered applications an indication of aresponsive action such as a UI manipulation, a data update in the pageof the EHR system, an automation of a sequence of interactions with theUI, processing of data from the page, or any other functionality that isto be performed in the page of the EHR system. For example, a responsiveaction may comprise an RPA that is configured to implement a sequence ofinteractions with the UI, such as a sequence of clicks on UI elements.In some cases, such as in case of a desktop agent, the EHR adapter mayobtain from the registered applications indications of one or moreadditional responsive actions such as copying text to a clipboard andproviding a pasted version of the text to the backend of the EHR system,or the like.

In some exemplary embodiments, the EHR adapter may provide to thesoftware agent an EHR-specific instruction to perform the responsiveactions. In some exemplary embodiments, the EHR-specific instruction maybe configured to enable the agent to perform a UI manipulation in thepage of the EHR system, a data update in the page of the EHR system, anAPI call, or the like, according to the instruction of the respectiveextending application.

In some exemplary embodiments, the software agent may execute the one ormore responsive actions over the page, such as by modifying the DOM ofthe page and loading the resource within iframes embedded in the page,performing an automation process with the user interface of the page, orthe like. In some exemplary embodiments, loading the resource over thepage may provide the user with an augmented functionality that is notavailable at the EHR system. In some exemplary embodiments, theresponsive action may be implemented as a manipulation of a GUI elementin an iframe, an overlay presented over the browsed page, as an injectedcode that is embedded in the page, as an activation of a code that isembedded in an iframe, or the like. In some exemplary embodiments, theloaded resources may be adapted to the EHR interface and combined orembedded therewith.

In some exemplary embodiments, the runtime infrastructure may be enabledto load new code and provision new functionality in real time, such asby changing the URL, changing a backend of a resource to which the URLpoints, loading a URL over a newly injected iframe, or the like, withoutchanging or modifying the software agent or the runtime infrastructure.In some exemplary embodiments, applications loaded in iframes may beadjusted or switched in real time by changing a URL or resource link ofan iframe with another link of an application from the retrieved list ofapplications, and reloading the resources. In some exemplaryembodiments, applications loaded in iframes may be adjusted or switchedin real time by changing a resource to which the URL points, a backendto which the URL points, or the like, e.g., with an updated version ofthe resource, without changing the URL itself. In some exemplaryembodiments, by enabling changes through authorized applications fromthe retrieved list of applications only, dangers imposed by a dynamicexecution of a string representing client-side code may be prevented.

For example, after the first event, the agent may monitor the DOM of thepage to identify a second event, indicate the second event to theruntime infrastructure, and, in response to the second event, obtain aninstruction from the runtime infrastructure to adjust an iframeembedding the extending application to point to a second extendingapplication, such as by changing a URL of the iframe. Alternatively, inresponse to the second event, the runtime infrastructure may instructthe agent to inject a new iframe in the page, and load a secondapplication in the new iframe. In some exemplary embodiments, theruntime infrastructure may comprise a software component for enabling toinstruct the agent to add on the fly new iframe elements, and to loadtherein resources such as information from the extending service, from athird party, or the like. In some exemplary embodiments, the runtimeinfrastructure may instruct the agent to insert additional iframes inthe DOM of the page in response to an event, a determination, anautomation execution, or the like. In some exemplary embodiments, theruntime infrastructure may modify and load extending applications overembedded iframes in EHR systems.

Referring now to FIG. 2 illustrating a flowchart diagram of a method, inaccordance with some exemplary embodiments of the disclosed subjectmatter.

On Step 210, an EHR-specific instruction, data, event indication, or thelike, may be obtained, at an EHR adapter, from a software agent e.g., inresponse to an indication of the EHR adapter indicating events ofinterest, GUI elements of interest, DOM elements of interest, or thelike, to the agent. In some exemplary embodiments, upon receiving theindication, the agent may monitor the elements of interest and identifyreal time events associated thereto such as events involving theelements of interest, interactions therewith, or the like. In someexemplary embodiments, in response to detecting an event of interest,the agent may generate an EHR-specific instruction indicating the eventof interest. In some exemplary embodiments, the EHR-specific event maycorrespond to the instructions of the EHR adapter that were provided tothe agent. In some exemplary embodiments, the EHR-specific instructionmay comprise an indication of an event that occurred in a DOM of a pageof the EHR system, such as in real time. In some exemplary embodiments,the EHR-specific event or instruction may be obtained in a form thatcorresponds to the API of the underlying EHR system, to its DOM layout,or the like.

On Step 220, the EHR-specific instruction may be converted to across-EHR instruction at the EHR adapter. In some exemplary embodiments,the EHR adapter may translate or convert the EHR-specific instructionindicating the event to a cross-EHR instruction that can be provided tothe runtime infrastructure, and from there to an extending application.In some exemplary embodiments, the cross-EHR instruction may comprise ageneral representation of the event, which can be used to describeevents from multiple different EHR systems to multiple extendingapplications through a single runtime infrastructure, or the like. Forexample, the general representation may comprise a representation thatcorresponds to a format, syntax or language that is used by theextending applications.

In some exemplary embodiments, the EHR adapter may be configured toconvert the event to a cross-application cross-EHR form, that can beprovided and processed by any extending application. Accordingly, therespective extending applications may not be privy to the EHR-specificevents, instructions, or the like, and may not have access thereto. Insome exemplary embodiments, the EHR-specific events, instructions, orthe like, in their EHR-specific form, may not be shared with theextending applications.

On Step 230, the EHR adapter may forward the cross-EHR instruction tothe runtime infrastructure, which may identify a registered extendingapplication. In some exemplary embodiments, the runtime infrastructuremay determine that an application is registered to the cross-EHRrepresentation of the event, e.g., based on application registration tocross-EHR cross-application events.

On Step 240, the cross-EHR instruction may be provided to the registeredapplication, e.g., indicating the event thereto. In some exemplaryembodiments, the runtime infrastructure may be configured to provide across-EHR indication of the event to registered applications that areregistered to the event, as identified at Step 230. In some exemplaryembodiments, the extending applications may be configured to utilizecross-EHR cross-application formats of events, instructions, or the likeonly, and may not be configured to handle EHR-specific instructions orevent indications.

In some exemplary embodiments, upon obtaining a cross-EHR instruction,event indication, or the like, an extending application may execute across-EHR business logic, e.g., in order to determine a cross-EHRresponse to the event. In some exemplary embodiments, the extendingapplications may each retain business logic that may be configured todetermine a responsive action for an identified event, such as amanipulation of a GUI component, an update of data, sending an API call,or the like.

On Step 250, a cross-EHR instruction may be received from theapplication, e.g., at the runtime infrastructure. In some exemplaryembodiments, the cross-EHR response may be provided from registeredapplications to the runtime infrastructure. In some exemplaryembodiments, the cross-EHR instruction may comprise a cross-EHRrepresentation of a responsive action from the application, that isintended to be implemented in response to the event. In some exemplaryembodiments, the responsive action may be configured to perform a UImanipulation in the page of the EHR system, to load a resource such as aGUI element, to present data, to perform a data update in the page ofthe EHR system, or the like, in response to the event.

On Step 260, the cross-EHR instruction may be provided from the runtimeinfrastructure to the EHR adapter, so that the EHR adapter can convertthe cross-EHR instruction to an EHR-specific instruction. In someexemplary embodiments, the EHR adapter may translate or convert thecross-EHR instruction to an EHR-specific instruction that can beimplemented directly by the software agent over the EHR system.

In some exemplary embodiments, the runtime infrastructure may beconfigured to communicate with extending applications using cross-EHRcross-application instructions, indications, or the like, that wereconverted by the EHR adapter or provided by the extending applications.In some exemplary embodiments, the EHR-based instruction may be providedto the agent in a form that can be executed over the specific EHRsystem, such as using a conversion to the specific EHR by the EHRadapter. Accordingly, the respective extending applications may not beprivy to the EHR-based instructions obtained by the agent, and may nothave access thereto.

In some exemplary embodiments, due to the conversions performed by theEHR adapter between EHR-specific formats and cross-EHR formats, thesoftware agent may be enabled to communicate indirectly with theextending applications, in order to indicate thereto events and obtaintherefrom responsive actions, e.g., via the runtime infrastructure.

Referring now to FIG. 3 showing a schematic illustration of an exemplaryenvironment, in accordance with some exemplary embodiments of thedisclosed subject matter.

In some exemplary embodiments, Environment 300 may comprise a softwareagent such as an Extension 330 of a browser containing separateportions, scripts, or the like, e.g., a Content 310, which may beconfigured to handle an access to the EHR interface, and a Background332, which may be configured to communicate with the backend of theextending service, such as via a rendering browser. In some exemplaryembodiments, Environment 300 may comprise an EHR System 320, which maynot be associated with the Extension 330 or with the extending serviceproviding the Extension 330. EHR System 320 may comprise an EHR DOM 322,containing the DOM representation of the EHR pages. In some exemplaryembodiments, Environment 300 may comprise an Extending Service 340,which may be configured to provide extending applications that can beexecuted over EHR systems, as well as EHR adapters for underlying EHRsystems such as EHR System 320.

In some exemplary embodiments, Extension 330 may be configured to beexecuted by a browser that is rendering EHR System 320. In someexemplary embodiments, a Background 332 script of Extension 330 maycomprise an Application Management 334 component and a User Management336 component, and may enable Background 332 to communicate with thebrowser such as in order to reach Extending Service 340 via the browserand obtain therefrom a list of applications.

In some exemplary embodiments, a Content 310 script of Extension 330 maycomprise an EHR DOM API 312 component, which may enable Content 310 tomonitor and modify the user interface or EHR DOM 322 of EHR System 320,such as by using hooks, API calls, or any other monitoring techniquethat can be used by a browser extension. In some exemplary embodiments,EHR DOM API 312 may contain a thin API layer which may access the DOM ofthe EHR application, e.g., EHR DOM 322 of EHR System 320, monitor EHRDOM 322 with any monitoring technique of browser extensions, scrape theEHR DOM 322, or the like. In some exemplary embodiments, Content 310 mayalso comprise an Iframe Injector 316 enabling to inject Widget Iframes326 and a Runtime Iframe 328 to EHR DOM 322. Runtime Iframe 328 maycomprise an iframe over which an EHR adapter or runtime infrastructuremay be executed, and may or may not be visible. Widget Iframes 326 maycomprise iframe over which extending applications may be loaded. Content310 may comprise a Message Bus 314 enabling to exchange messages withthe injected iframes.

In order to load an EHR adapter in Runtime Iframe 328, Content 310 mayobtain the EHR adapter from Extending Service 340 such as via Background332, which may provide it to Content 310, and enable Content 310 to loadthe adapter within Runtime Iframe 328. For example, Background 332 maysend Extending Service 340 a request to obtain an adapter to EHR System320, and in response, Background 332 may obtain the adapter. In order toload extending applications in Widget Iframes 326, Content 310 mayobtain the applications from Extending Service 340 such as viaBackground 332, which may provide it to Content 310. In some exemplaryembodiments, Background 332 may obtain from Extending Service 340 anadapter that is adapted to the specific EHR System 320, a list ofapplications that match EHR System 320 and are authorized for the useraccount, e.g., according to Application Management 334 which may pullits data from Extending Service 340, or the like. Background 332 mayforward the data to Content 310. In some exemplary embodiments,Application Management 334 in Background 332 may be configured todetermine a list of applications or data from the storage of ExtendingService 340 or from any other location that can be loaded for the user,e.g., applications that are authorized for the user according to theuser's workplace, membership, organization, identity, account, or thelike, according to user categories or properties determined by UserManagement 336 (which may pull its data from Extending Service 340), orthe like. In some exemplary embodiments, User Management 336 maydetermine permissions of a user account. For example, User Management336 may indicate that the user only has permission to access datarecords that belong to the user, and data records that describeproviders with which the user's payer works. In some exemplaryembodiments, Application Management 334 may determine that a list of oneor more extending applications can be loaded for a current user or useraccount, e.g., in accordance with the user's permissions determined byUser Management 336, in accordance with a context of EHR System 320, inaccordance with loaded configurations relating to the user,configurations relating to the user's organization, configurationsrelating to the user's installed applications, or the like. For example,the list of applications may comprise applications that the user haspermission to access and are relevant to a browsed page. In someexemplary embodiments, Iframe Injector 316 may inject for the obtainedapplications respective Widget Iframes 326.

In some exemplary embodiments, Extension 330 may access the DOM of theEHR System 320, e.g., EHR DOM 322. Extension 330 is enabled to accessEHR DOM 322 due to EHR DOM API 312 of Content 310, which provides for anAPI for accessing and potentially manipulating EHR DOM 322. In someexemplary embodiments, in order to enable the Extending Service 340 toprovide an extending application in a secure and privacy-retainingmanner, Extension 330 may verify the user's identity prior to loadingRuntime Iframe 328, e.g., by scraping the user's EHR credentials andutilizing them for a sign in process of Extending Service 340, byutilizing a Single Sign-On (SSO) flow without scraping the user's EHRcredentials, or in any other way.

In some exemplary embodiments, Iframe Injector 316 may load the EHRadapter in the Runtime Iframe 328 such as by embedding therein a URLthat points to Extending Service 340 or any other EHR adapting source.In some exemplary embodiments, Runtime Iframe 328 may load the adapterfrom a platform of Extending Service 340, e.g., by executing the URL. Insome exemplary embodiments, Runtime Iframe 328 may function as anadapter between Extension 330 and Widget Iframes 326, enabling Extension330 to forward events to Widget Iframes 326 via a conversion or adaptionof Runtime Iframe 328.

In some exemplary embodiments, Runtime Iframe 328 may be configured tocommunicate with both Extending Service 340 and Extension 330. RuntimeIframe 328 may communicate with Extending Service 340 by exchangingHypertext Transfer Protocol (HTTP) API calls with a platform ofExtending Service 340. In some exemplary embodiments, Runtime Iframe 328may be configured to communicate with Extension using one or morecommunication protocols or methods such as a “postMessage” method, orany other communication method that may enable cross-origincommunication between an iframe and a browser extension. For example,the postMessage method may enable Runtime Iframe 328 to communicate withExtension 330, via Message Bus 314 of Extension 330, via EHR DOM API312, or the like. Iframes such as Widget Iframes 326 and a RuntimeIframe 328 may also communicate with each other using postMessagecommunications, or any other communication type. The messages of RuntimeIframe 328 with Extension 330 may comprise in-browser messages that maybe wrapped in an Inter-Process Communication (IPC)-like interface. Insome exemplary embodiments, using an IPC interface, iframes such asRuntime Iframe 328 may communicate with Extension 330, as part of theapplication abstraction. Background 332 may communicate with ExtendingService 340 via HTTP messages. In some exemplary embodiments, WidgetIframes 326 may communicate HTTP-based API calls, or any other type ofcommunications, with Extending Service 340. In some exemplaryembodiments, Widget Iframes 326 may communicate with Message Bus 314,Runtime Iframe 328, or the like, using one or more communicationprotocols or methods such as a postMessage communication method.

In some exemplary embodiments, EHR DOM API 312 may monitor events in EHRSystem 320 and update Runtime Iframe 328 regarding events that occurredin the EHR DOM 322, e.g., in case they match a defined whitelist ofevents, do not match a blacklist of events, are defined as events ofinterest, or the like. Widget Iframes 326 may not have any access to theDOM of the page, e.g., EHR DOM 322. Therefore, in order to obtaininformation about the page events and data, Widget Iframes 326 may beinformed about any page data or events via Runtime Iframe 328, which maybe informed of such data from EHR DOM API 312 of the Content 310. Insome exemplary embodiments, upon obtaining indications of events fromExtension 330, which may be provided in an EHR-specific format, such asvia Message Bus 314, Runtime Iframe 328 may notify the iframes of WidgetIframes 326 regarding the events. Runtime Iframe 328 may obtain DOMevents that are monitored by EHR DOM API 312, and indicate the events toregistered applications of Widget Iframes 326 that are registered to theevents, to subscribed iframes, to all iframes, or the like, so that theycan respond to the events in case such a response is configured to beprovided.

In some exemplary embodiments, an EHR adapter to EHR System 320, whichmay be comprised in Runtime Iframe 328, may be configured to convert ortranslate EHR-specific data from Extension 330 to a cross-EHR format,with which the applications loaded in Widget Iframes 326 maycommunicate, process, execute, or the like. The cross-EHR format maycomprise an abstraction layer of events that may be used by theapplications, e.g., all the extending applications, a unified formatthereof, or the like. In some exemplary embodiments, each EHR systemsuch as EHR System 320 may retain data records in different formats,orders, syntax, protocols, or the like, thereby requiring an EHR adapterto mediate between the applications and each EHR System 320. AlthoughRuntime Iframe 328 may match a vendor of a certain EHR system, such asEHR System 320, the events and protocols used by Runtime Iframe 328 maybe identical for all EHR systems, enabling instances of Runtime Iframe328 to handle multiple extending applications from various sources.

In some exemplary embodiments, the registered applications loaded inWidget Iframes 326 may obtain the cross-EHR data from Runtime Iframe328, and execute business logic to determine a responsive action for theevent. In some exemplary embodiments, Runtime Iframe 328 may obtaincross-EHR responses to events from the registered applications, andadapt the cross-EHR responses to EHR-specific API calls or otherEHR-specific instructions that can be executed or implemented byExtension 330 over EHR System 320. Runtime Iframe 328 may provide theEHR-specific instructions to Message Bus 314 in a format that matchesthe underlying EHR system. In some exemplary embodiments, in response toobtaining the EHR-specific instructions from Message Bus 314, EHR DOMAPI 312 component in Content 310 may be configured to generate API callssuch as calls to update an element in the DOM of the EHR system, callsto record an element from the DOM, send the API calls to EHR System 320,or the like. For example, EHR DOM API 312 may add one or more GUIelements to the DOM in response to instructions from Runtime Iframe 328.In case Runtime Iframe 328 determines that, in response to an event, anadditional iframe is needed to load an additional application, a requestmay be made to Extension 330 to inject a new iframe, e.g., via IframeInjector 316. Iframe Injector 316 may inject one or more iframes in EHRDOM 322, in response to the instructions, so that one or more additionalapplications could be executed therein.

In some exemplary embodiments, Runtime Iframe 328 may enable todynamically modify or load extending applications over Widget Iframe326. In some exemplary embodiments, Runtime Iframe 328 may obtain fromExtending Service 340 a list of applications and load them above WidgetIframe 326 in EHR DOM 322, such as by embedding in each iframe an URL ofthe respective extending application. In some exemplary embodiments,upon determining that a new application should replace a currentapplication running in an iframe, Runtime Iframe 328 may modify theiframe in real time by changing its URL and replacing it with a URL ofthe new application, adjusting parameters within the URL, removing theiframe and replacing it with a new iframe pointing to the newapplication, or the like. In some exemplary embodiments, theapplications that are loaded in Widget Iframes 326 may be modified byinserting a different URL in the iframe, e.g., by Runtime Iframe 328,thereby causing the iframe to point to a different URL or resource.Widget Iframe 326 may load resources of an extending application from aplatform of Extending Service 340, e.g., directly by executing the URL,via Runtime Iframe 328, or the like. For example, an applicationexecuting in Widget Iframe 326 may be configured to determine aresponsive action to an event, such as including loading from ExtendingService 340 a list of providers that are supported by the user's payer,in case EHR DOM API 312 indicates that the data is missing in EHR System320. In some exemplary embodiments, the data may be adapted to the EHRinterface of EHR System and combined or embedded therewith, e.g., by theapplication, Extension 330, or the like.

In some exemplary embodiments, an exemplary pseudo code for utilizingEnvironment 300 may comprise a configuration of the disclosedcomponents, e.g., as follows:

/*

*

*Background

*

*/

const {applications, adapter}=getUser( ); // API call to extendingserver sendToContent(‘initMsg’, applications, adapter);

/*

*

* Content

*

*/

const Events = {

-   -   getAttribute: (params) => { },    -   scrape: (params) => { },    -   fetchData: (params) => { },    -   reloadWindow: (params) => { },    -   injectWidget: (params) => { },    -   // . . .        };        // Create listener to events from Background        createBackgroundListener(message => {

if (message === ‘initMsg’) {

-   -   const runtimeFrame = createRuntimeIframe(‘runtime.get.com’,        adapter, applications);    -   DOM.add(runtimeFrame);

}

});

// Create message bus to events from iframe adapters

DOM. addEventListener(‘message’, event => {

if (event is in Events) {

-   -   const response = event( ); //execute the event and get the        response    -   event. adapter. sendResponse(response);

}

});

As described by the pseudo code, Background 332 may have access tocommunications with an executing browser, via which Background 332 mayreach Extending Service 340 and communicate therewith. Background 332may obtain from Extending Service 340 an EHR adapter for EHR System 320to be loaded in Runtime Iframe 328, and a list of applications that areto be executed in Widget Iframe 326. Background 332 may forward the dataregarding the EHR adapter and the list of applications to Content 310via an initialization message.

In some exemplary embodiments, inside Content 310, an API such as EHRDOM API 312 component may be configured to exchange calls with a DOM ofan EHR page, e.g., EHR DOM 322, enabling to obtain data from the DOM,instruct actions to occur in the DOM, add data to the DOM, or the like.Content 310 may have access to EHR DOM 322, from which Content 310 mayidentify events, obtain attribute parameters, scrape parameters, fetchdata, or the like. Content 310 may be enabled to modify EHR DOM 322 suchas by reloading a window, injecting an iframe, or the like. In somecases, actions performed by Content 310 or monitored by Content 310 maymatched against a defined Events object, such as indicating events ofinterest.

In some exemplary embodiments, upon obtaining the initialization messagefrom Background 332, Content 310 may identify the message as aninitialization message of the user, and inject an initial listener suchas Runtime Iframe 328 into EHR DOM 322, e.g., by Iframe Injector 316.Iframe Injector 316 may initialize Runtime Iframe 328 with a URL or linkthat is associated to the EHR adapter, enabling the EHR adapter to beloaded therein. In some cases, Iframe Injector 316 may inject one ormore additional iframes such as Widget Iframes 326 for the extendingapplications, over which Runtime Iframe 328 may load the applications,e.g., as part of a loading process of the extending applications.

In some exemplary embodiments, Message Bus 314 may be created by Content310 for facilitating communications of events between Content 310 andRuntime Iframe 328. In case Content 310 determines that an identifiedevent matches the defined Events object, a defined whitelist, or thelike, Message Bus 314 may notify Runtime Iframe 328 of the event.Runtime Iframe 328 may convert the EHR-specific event to a cross-EHRevent, which may be provided to registered applications loading overWidget Iframes 326. In some exemplary embodiments, the extendingapplications may be configured to determine a response to the event, andindicate the respond to Runtime Iframe 328 as a cross-EHR instruction toimplement an action over EHR System 320, e.g., to manipulate a GUIelement presented by the respective iframe, to execute an automationcode in the iframe, or the like. Runtime Iframe 328 may convert thecross-EHR instruction to an EHR-specific instruction that can beexecuted over EHR System 320, and forward the EHR-specific action toMessage Bus 314, which may enable to execute the action such as byforwarding the action to EHR DOM API 312.

In some exemplary embodiments, any other configuration may be utilized.For example, instead of implementing Runtime Iframe 328 differently foreach EHR system, Runtime Iframe 328 may be implemented in a single formfor multiple EHR systems that may have a similar syntax. In such cases,Extension 330 may not necessarily be required to contact ExtendingService 340 prior to loading Runtime Iframe 328. In some cases, in caseof a single Runtime Iframe 328, Extension 330 may contact ExtendingService 340 prior to loading Runtime Iframe 328 such as in order toobtain updated versions of Runtime Iframe 328, of URLs of the RuntimeIframe 328 or applications, of Extension 330, or the like. In somecases, any other widget may be used instead of iframes, in case theyenable to load applications therein and communicate with the softwareagent.

Referring now to FIG. 4 showing a schematic illustration of an exemplaryenvironment, in accordance with some exemplary embodiments of thedisclosed subject matter.

In some exemplary embodiments, Environment 400 may comprise an Extension430, which may correspond to Extension 330 (FIG. 3). In some exemplaryembodiments, Extension 430 may comprise a Hooks Subscribe 432, an EHRDOM API 434, and an Iframe Injector 436. In some exemplary embodiments,Hooks Subscribe 432 may enable Extension 430 to monitor events usinghooks, instead of or in addition to utilizing API calls to obtain EHRelements via EHR DOM API 434.

In some exemplary embodiments, Environment 400 may comprise an EHRAdapter 420 and Runtime Infrastructure 450, which may correspond,together, to Runtime Iframe 328 (FIG. 3). In some exemplary embodiments,EHR Adapter 420 may comprise an EHR Monitor 422 and an EHR CommandConverter 424, which may be configured to interpret the DOM of the EHRpage, obtain EHR events from Extension 430 and convert the events to across-EHR representation, respectively. In some exemplary embodiments,Runtime Infrastructure 450 may obtain cross-EHR Standard Events 452 fromEHR Adapter 420, identify whether the events obtained from Extension 430indicate changes such as a Data Change 453, a new Data State 455, aWorkflow Changed Event 454, or the like. In some exemplary embodiments,Runtime Infrastructure 450 may comprise Publish Subscribe Channel 456,which may determine which Applications 460 that are loading in the pageare subscribed to one or more of the events or changes, and indicate theevents to the applications, e.g., via postMessage communications. Forexample, an application may be registered to a certain data change, to acertain data state, to a workflow state, or the like.

In some exemplary embodiments, Environment 400 may comprise anApplications 460, which may correspond to the applications loading overWidget Iframes 326 (FIG. 3). In some exemplary embodiments, Applications460 may comprise a plurality of applications that are configured to beexecuted in iframes over EHR systems, to provide a functionality inresponse to an EHR event, or the like. An Application 460 may compriseany augmented functionality or data that is configured to provideaugmented functionality over any EHR system, certain types thereof, orthe like. Each Application 460 may subscribe to certain data or workflowevents in the EHR system, and determine a functionality for the EHRdisplay in case a subscribed event is identified by EHR Adapter 420. Insome exemplary embodiments, Applications 460 may comprise applicationsthat are obtained from an open marketplace enabling unauthorized vendorsto provide applications, even in case they have no granted access tosensitive or private user data, e.g., PHI data.

In some exemplary embodiments, in order to prevent from Applications 460to access any PHI data, Applications 460 may only be enabled tocommunicate with Runtime Infrastructure 450, which may provide theretocross-EHR non-sensitive information of events that were converted by EHRAdapter 420, without user data. In some exemplary embodiments, onlyApplications 460 that are registered to a specific event or state may benotified in case such event occurs, which may further limit the accessto such events. In some exemplary embodiments, in some cases,Applications 460 may be enabled to provide an offline response, withoutconnecting to a providing server of the application's vendor, therebyfurther limiting any information about the event that is accessible tothe providing server, as the server may not be aware that the responseof its application has been executed. Alternatively, Applications 460may be enabled to provide an online response, utilizing a connection toa providing server. In some exemplary embodiments, Application State andStorage 463 may retain the current state and the storage of theapplication, which may or may not enable offline event handling.

In some exemplary embodiments, Applications 460 may comprise a StandardEvents Handler 462, which may obtain an indicated cross-EHR event fromRuntime Infrastructure 450, and provide the event indication to BusinessLogic (BL) 464. BL 464 may comprise a function, code, or the like, thatmay be executed in response to the event, in order to determine aresponse to the event. BL 464 may utilize a Response Builder 466 togenerate cross-EHR instructions for execution by Extension 430. ResponseBuilder 466 may forward cross-EHR instructions to EHR Adapter 420, whichmay convert the instructions to EHR-specific instructions that can beexecuted over the underlying EHR system by Extension 430. EHR Adapter420 may provide the converted EHR-specific instructions to Extension430, which may execute the instructions, implement them, or the like. Incase the desired response includes a modification of a UI component inthe respective iframe, BL 464 may utilize Widgets API 468 for adding GUIelements to UI Components 470, manipulating UI Components 470, or thelike. For example, BL 464 may configure Widgets API 468 to add a ButtonWidget 472 to the display, to modify an Iframe Widget 474, or the like.

In some exemplary embodiments, Extension 430 may be cross-EHR andcross-application, as it may be used for multiple EHR system andmultiple Applications 460, similarly to the underlying operating systembeing cross-EHR and cross-application. EHR Adapter 420 may notnecessarily be cross-EHR, as it may be configured to convert thecross-EHR semantics to EHR-specific semantics of Extension 430, theunderlying EHR system, or the like. In some cases, EHR Adapter 420 andRuntime Infrastructure 450 may be tailored to match a specific EHRsystem, to which and from which the cross-EHR semantics may beconverted. In some cases, EHR Adapter 420 may be tailored to match aspecific EHR system, while Runtime Infrastructure 450 may match multipleEHR systems, e.g., may be partly reusable.

In some exemplary embodiments, in order for the architecture ofEnvironment 400 to function properly for desktop EHR applications, thatare not executed by a browser, EHR Adapter 420 may be replaced with oneor more desktop adapters, and Extension 430 may be replaced with asoftware agent that can be executed over desktop applications, such as asniffer, a computer vision agent, DLL injections, a WinAPI agent, areverse engineering agent, or the like.

Referring now to FIG. 5 showing a schematic illustration of an exemplaryenvironment, in accordance with some exemplary embodiments of thedisclosed subject matter.

As illustrated in FIG. 5, one or more agents such as Extension 530,Computer Vision Agent 540, Digital Signals Agents 550, or the like, maybe configured to monitor events of an EHR interface. The agents maycorrespond to Extension 330 (FIG. 3). The identified events may beprovided to one or more Adapters 520, which may be configured tostandardize the identified events to a normalized language orrepresentation that is used by all applications. Adapters 520 maycorrespond to Runtime Iframe 328 (FIG. 3). Adapters 520 may determinewhether each Application 560 is registered to an event, and in case itis, an Adapter 520 may indicate to Application 560 that the event hasoccurred, with or without any specific or sensitive information aboutthe event. For example, Adapter 520 may indicate that a type of userinteraction has occurred, without indicating which GUI element wasinteracted with, which user account was activated during the session, orthe like.

In some exemplary embodiments, Application 560 may be configured toperform a responsive action such as to load one or more GUI elements, toperform code executions, or the like, over the EHR system, in responseto the event. Applications 560 may correspond to Widget Iframes 326(FIG. 3). In some exemplary embodiments, Application 560 may beconfigured to determine a responsive action in a cross-EHR format. Insome exemplary embodiments, Application 560 may provide the responsiveaction to one or more Adapters 520, which may convert the responsiveaction to an EHR-specific command that matches the underlying EHR systemthat is being used, is launched, is executing, or the like. TheEHR-specific command may be provided to an agent such as Extension 530,Computer Vision Agent 540, Digital Signals Agents 550, which may executethe command.

Referring now to FIG. 6 showing a block diagram of an apparatus, inaccordance with some exemplary embodiments of the disclosed subjectmatter.

In some exemplary embodiments, an Apparatus 600 may comprise a Processor602. Processor 602 may be a Central Processing Unit (CPU), amicroprocessor, an electronic circuit, an Integrated Circuit (IC) or thelike. Processor 602 may be utilized to perform computations required byApparatus 600 or any of its subcomponents. Processor 602 may beconfigured to execute computer-programs useful in performing the methodsof FIGS. 1-2, or the like.

In some exemplary embodiments of the disclosed subject matter, anInput/Output (I/O) Module 605 may be utilized to provide an output toand receive input from a user. I/O Module 605 may be used to transmitand receive information to and from the user or any other apparatus,e.g., a plurality of user devices, in communication therewith.

In some exemplary embodiments, Apparatus 600 may comprise a Memory Unit607. Memory Unit 607 may be a short-term storage device or long-termstorage device. Memory Unit 607 may be a persistent storage or volatilestorage. Memory Unit 607 may be a disk drive, a Flash disk, a RandomAccess Memory (RAM), a memory chip, or the like. In some exemplaryembodiments, Memory Unit 607 may retain program code operative to causeProcessor 602 to perform acts associated with any of the subcomponentsof Apparatus 600. In some exemplary embodiments, Memory Unit 607 mayretain program code operative to cause Processor 602 to perform actsassociated with any of the steps in FIGS. 1-2, or the like.

The components detailed below may be implemented as one or more sets ofinterrelated computer instructions, executed for example by Processor602 or by another processor. The components may be arranged as one ormore executable files, dynamic libraries, static libraries, methods,functions, services, or the like, programmed in any programming languageand under any computing environment.

In some exemplary embodiments, Events Monitor 610 may be configured tomonitor an EHR system that is being executed on a user device, an enddevice, or the like. Events Monitor 610 may identify one or more events,states, or the like, for which one or more extending applications may beregistered, such as using hooks, API calls, or the like. For example,Events Monitor 610 may be part of an agent such as a browser extension,e.g., a CHROME™ browser, a desktop agent, or the like.

In some exemplary embodiments, Conversion Module 620 may be configuredto obtain EHR-specific event indications from Events Monitor 610, andconvert them to a cross-EHR representation that may be provided toregistered applications. Upon obtaining from the registered applicationsa cross-EHR instruction to perform a responsive action, ConversionModule 620 may be configured to convert the a cross-EHR instruction toan EHR-specific instruction such as an EHR-specific API call to the EHRsystem.

In some exemplary embodiments, Iframe Handler 630 may comprise runtimeinfrastructure that is configured to be loaded over a runtime iframe,load Conversion Module 620, and load one or more extending applicationover widget iframes. In some exemplary embodiments, in case anadditional application is intended to be loaded, Iframe Handler 630 mayinstruct Events Monitor 610 to inject an additional iframe, and load theadditional application therein. In some exemplary embodiments, IframeHandler 630 may be enabled to adjust applications in real time, such asby modifying a URL of an iframe, modifying a source code to which theiframe points, or the like. In some exemplary embodiments, IframeHandler 630 may communicate with the iframes directly, and provideoutputs from the iframes to Conversion Module 620.

In some exemplary embodiments, Data Accumulator 640 may be configured toaccumulate data from an EHR system, a DOM thereof, or the like, andprovide the data to a storage of the extending service. For example,Data Accumulator 640 may obtain state indications, event indications,screenshots, or the like, from Events Monitor 610.

The present invention may be a system, a method, and/or a computerprogram product. The computer program product may include a computerreadable storage medium (or media) having computer readable programinstructions thereon for causing a processor to carry out aspects of thepresent invention.

The computer readable storage medium can be a tangible device that canretain and store instructions for use by an instruction executiondevice. The computer readable storage medium may be, for example, but isnot limited to, an electronic storage device, a magnetic storage device,an optical storage device, an electromagnetic storage device, asemiconductor storage device, or any suitable combination of theforegoing. A non-exhaustive list of more specific examples of thecomputer readable storage medium includes the following: a portablecomputer diskette, a hard disk, a random access memory (RAM), aread-only memory (ROM), an erasable programmable read-only memory (EPROMor Flash memory), a static random access memory (SRAM), a portablecompact disc read-only memory (CD-ROM), a digital versatile disk (DVD),a memory stick, a floppy disk, a mechanically encoded device such aspunch-cards or raised structures in a groove having instructionsrecorded thereon, and any suitable combination of the foregoing. Acomputer readable storage medium, as used herein, is not to be construedas being transitory signals per se, such as radio waves or other freelypropagating electromagnetic waves, electromagnetic waves propagatingthrough a waveguide or other transmission media (e.g., light pulsespassing through a fiber-optic cable), or electrical signals transmittedthrough a wire.

Computer readable program instructions described herein can bedownloaded to respective computing/processing devices from a computerreadable storage medium or to an external computer or external storagedevice via a network, for example, the Internet, a local area network, awide area network and/or a wireless network. The network may comprisecopper transmission cables, optical transmission fibers, wirelesstransmission, routers, firewalls, switches, gateway computers and/oredge servers. A network adapter card or network interface in eachcomputing/processing device receives computer readable programinstructions from the network and forwards the computer readable programinstructions for storage in a computer readable storage medium withinthe respective computing/processing device.

Computer readable program instructions for carrying out operations ofthe present invention may be assembler instructions,instruction-set-architecture (ISA) instructions, machine instructions,machine dependent instructions, microcode, firmware instructions,state-setting data, or either source code or object code written in anycombination of one or more programming languages, including an objectoriented programming language such as Smalltalk, C++ or the like, andconventional procedural programming languages, such as the “C”programming language or similar programming languages. The computerreadable program instructions may execute entirely on the user'scomputer, partly on the user's computer, as a stand-alone softwarepackage, partly on the user's computer and partly on a remote computeror entirely on the remote computer or server. In the latter scenario,the remote computer may be connected to the user's computer through anytype of network, including a local area network (LAN) or a wide areanetwork (WAN), or the connection may be made to an external computer(for example, through the Internet using an Internet Service Provider).In some embodiments, electronic circuitry including, for example,programmable logic circuitry, field-programmable gate arrays (FPGA), orprogrammable logic arrays (PLA) may execute the computer readableprogram instructions by utilizing state information of the computerreadable program instructions to personalize the electronic circuitry,in order to perform aspects of the present invention.

Aspects of the present invention are described herein with reference toflowchart illustrations and/or block diagrams of methods, apparatus(systems), and computer program products according to embodiments of theinvention. It will be understood that each block of the flowchartillustrations and/or block diagrams, and combinations of blocks in theflowchart illustrations and/or block diagrams, can be implemented bycomputer readable program instructions.

These computer readable program instructions may be provided to aprocessor of a general purpose computer, special purpose computer, orother programmable data processing apparatus to produce a machine, suchthat the instructions, which execute via the processor of the computeror other programmable data processing apparatus, create means forimplementing the functions/acts specified in the flowchart and/or blockdiagram block or blocks. These computer readable program instructionsmay also be stored in a computer readable storage medium that can directa computer, a programmable data processing apparatus, and/or otherdevices to function in a particular manner, such that the computerreadable storage medium having instructions stored therein comprises anarticle of manufacture including instructions which implement aspects ofthe function/act specified in the flowchart and/or block diagram blockor blocks.

The computer readable program instructions may also be loaded onto acomputer, other programmable data processing apparatus, or other deviceto cause a series of operational steps to be performed on the computer,other programmable apparatus or other device to produce a computerimplemented process, such that the instructions which execute on thecomputer, other programmable apparatus, or other device implement thefunctions/acts specified in the flowchart and/or block diagram block orblocks.

The flowchart and block diagrams in the Figures illustrate thearchitecture, functionality, and operation of possible implementationsof systems, methods, and computer program products according to variousembodiments of the present invention. In this regard, each block in theflowchart or block diagrams may represent a module, segment, or portionof instructions, which comprises one or more executable instructions forimplementing the specified logical function(s). In some alternativeimplementations, the functions noted in the block may occur out of theorder noted in the figures. For example, two blocks shown in successionmay, in fact, be executed substantially concurrently, or the blocks maysometimes be executed in the reverse order, depending upon thefunctionality involved. It will also be noted that each block of theblock diagrams and/or flowchart illustration, and combinations of blocksin the block diagrams and/or flowchart illustration, can be implementedby special purpose hardware-based systems that perform the specifiedfunctions or acts or carry out combinations of special purpose hardwareand computer instructions.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising,” when used in this specification, specify thepresence of stated features, integers, steps, operations, elements,and/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components, and/or groups thereof.

The corresponding structures, materials, acts, and equivalents of allmeans or step plus function elements in the claims below are intended toinclude any structure, material, or act for performing the function incombination with other claimed elements as specifically claimed. Thedescription of the present invention has been presented for purposes ofillustration and description, but is not intended to be exhaustive orlimited to the invention in the form disclosed. Many modifications andvariations will be apparent to those of ordinary skill in the artwithout departing from the scope and spirit of the invention. Theembodiment was chosen and described in order to best explain theprinciples of the invention and the practical application, and to enableothers of ordinary skill in the art to understand the invention forvarious embodiments with various modifications as are suited to theparticular use contemplated.

What is claimed is:
 1. An apparatus comprising: a processor, and amemory, wherein said memory retaining a browser extension that isconfigured, when executed by said processor, to monitor and interactwith a Document Object Model (DOM) of a page of an Electronic HealthRecord (EHR) system, wherein the browser extension is configured to beexecuted by a browser, wherein the browser is configured to render thepage of the EHR system; a runtime infrastructure that is loaded,dynamically, in the page of the EHR system in a first iframe, whereinthe runtime infrastructure lacks a Graphical User Interface (GUI)representation; an EHR-specific EHR adapter that is loaded, dynamically,in the page of the EHR system; and an extending application that isloaded, dynamically, in the page of the EHR system in a second iframe,wherein the browser extension is configured to inject the first iframein the page of the EHR system and cause the runtime infrastructure to beloaded into the first iframe, wherein the browser extension isconfigured to inject the second iframe in the page of the EHR system andenable the runtime infrastructure to load the extending application intothe second iframe, wherein the EHR-specific EHR adapter is specificallydesigned based on the EHR system, wherein the EHR-specific EHR adapteris configured to receive EHR-specific instructions from the browserextension and communicate converted cross-EHR instructions to theruntime infrastructure, wherein the runtime infrastructure is configuredto communicate the converted cross-EHR instructions to the extendingapplication, wherein the runtime infrastructure is configured to receivecross-EHR instructions from the extending application, wherein theEHR-specific EHR adapter is configured to obtain the cross-EHRinstructions and communicate converted EHR-specific instructions to thebrowser extension, wherein said apparatus is configured to implement afunctionality that is not provided by the EHR system at least by:monitoring, by the browser extension, for an event in the EHR system;notifying, by the browser extension, the EHR-specific EHR adapter of theevent via an EHR-specific instruction; translating, by the EHR-specificEHR adapter, the EHR-specific instruction to a converted cross-EHRinstruction that is provided to the extending application via theruntime infrastructure; executing, by the extending application, across-EHR business logic in response to the converted cross-EHRinstruction to determine a cross-EHR response; and translating, by theEHR-specific EHR adapter, the cross-EHR response to a convertedEHR-specific instruction that can be implemented by the browserextension over the EHR system.
 2. The apparatus of claim 1, wherein theextending application comprises a GUI component, wherein the businesslogic is configured to manipulate the GUI component.
 3. The apparatus ofclaim 1, wherein the extending application is an automation process,wherein the automation process lacks a GUI representation.
 4. Theapparatus of claim 1, wherein the runtime infrastructure is configuredto: retrieve from a server a list of applications to be loaded in thepage, wherein the list of applications to be loaded comprises at leastthe extending application, wherein the runtime infrastructure isconfigured to dynamically load the extending application in the secondiframe by provisioning a Uniform Resource Locator (URL) to be loaded inthe second iframe, wherein the URL is pointing to a code of theextending application, whereby the apparatus is enabled to load new codeand provision new functionality by changing the code or changing the URLwithout changing the browser extension, whereby the apparatus prevents adynamic execution of a string representing client-side code.
 5. Theapparatus of claim 4, wherein the list of applications to be loaded isdetermined based on access permissions of a user of the EHR system toapplications in an application repository.
 6. The apparatus of claim 1,wherein the cross-EHR response is configured to perform a User Interface(UI) manipulation in the page of the EHR system or a data update in thepage of the EHR system.
 7. The apparatus of claim 1, wherein the browserextension is configured to inject the EHR-specific EHR adapter in thepage of the EHR system and load the EHR-specific EHR adapter.
 8. Theapparatus of claim 1, wherein the runtime infrastructure is configuredto retrieve from a server a list of applications to be loaded in thepage, wherein the list of applications to be loaded comprises theextending application and a second application, wherein the extendingapplication belongs to a first organization associated with a firstserver, wherein the second application belongs to a second organizationassociated with a second server, wherein the runtime infrastructure isconfigured to dynamically load the second application in a third iframeembedded in the page by provisioning a Uniform Resource Locator (URL) tobe loaded in the third iframe, wherein the URL is pointing to a code ofthe second application.
 9. The apparatus of claim 1, wherein the runtimeinfrastructure is configured to retrieve from a server a list ofapplications to be loaded in the page, wherein the list of applicationsto be loaded comprises the extending application and a secondapplication, wherein the extending application belongs to a firstorganization associated with a first server, wherein the secondapplication belongs to a second organization associated with a secondserver, wherein the runtime infrastructure is configured to dynamicallyload the second application in the second iframe by provisioning aUniform Resource Locator (URL) of the second application to be loaded inthe second iframe, wherein the URL of the second application is pointingto a code of the second application, wherein the URL of the secondapplication replaces a URL of the extending application.
 10. Theapparatus of claim 9, wherein the runtime infrastructure is configuredto dynamically load the second application in the second iframe inresponse to a second event.
 11. The apparatus of claim 1, wherein a listof applications is available in a marketplace, wherein any provider isenabled to upload a new application to the marketplace, wherein a userof the EHR system is enabled to install in a user device any applicationfrom the marketplace.
 12. The apparatus of claim 1, wherein theEHR-specific EHR adapter is configured to indicate to the browserextension an element of interest via an indication, wherein the browserextension is configured to monitor the element of interest in responseto the indication, wherein the browser extension is configured to notifythe EHR-specific EHR adapter of the EHR-specific instruction in responseto monitoring the event, wherein the event is associated to the elementof interest.
 13. The apparatus of claim 1, wherein the browser extensionis configured to inject the first and second iframes in response todetermining that the extending application is configured to be loadedover the page of the EHR system.
 14. A computer program productcomprising a non-transitory computer readable medium retaining programinstructions, which program instructions when read by a processor, causethe processor to: monitor and interact with a Document Object Model(DOM) of a page of an Electronic Health Record (EHR) system using abrowser extension, wherein the browser extension is configured to beexecuted by a browser, wherein the browser is configured to render thepage of the EHR system; dynamically load a runtime infrastructure in thepage of the EHR system in a first iframe, wherein the runtimeinfrastructure lacks a Graphical User Interface (GUI) representation;dynamically load an EHR-specific EHR adapter in the page of the EHRsystem; and dynamically load an extending application in the page of theEHR system in a second iframe, wherein the browser extension isconfigured to inject the first iframe in the page of the EHR system andcause the runtime infrastructure to be loaded into the first iframe,wherein the browser extension is configured to inject the second iframein the page of the EHR system and enable the runtime infrastructure toload the extending application into the second iframe, wherein theEHR-specific EHR adapter is specifically designed based on the EHRsystem, wherein the EHR-specific EHR adapter is configured to receiveEHR-specific instructions from the browser extension and communicateconverted cross-EHR instructions to the runtime infrastructure, whereinthe runtime infrastructure is configured to communicate the convertedcross-EHR instructions to the extending application, wherein the runtimeinfrastructure is configured to receive cross-EHR instructions from theextending application, wherein the EHR-specific EHR adapter isconfigured to obtain the cross-EHR instructions and communicateconverted EHR-specific instructions to the browser extension, whereinsaid processor is configured to implement a functionality that is notprovided by the EHR system at least by: monitoring, by the browserextension, for an event in the EHR system; notifying, by the browserextension, the EHR-specific EHR adapter of the event via an EHR-specificinstruction; translating, by the EHR-specific EHR adapter, theEHR-specific instruction to a converted cross-EHR instruction that isprovided to the extending application via the runtime infrastructure;executing, by the extending application, a cross-EHR business logic inresponse to the converted cross-EHR instruction to determine a cross-EHRresponse; and translating, by the EHR-specific EHR adapter, thecross-EHR response to a converted EHR-specific instruction that can beimplemented by the browser extension over the EHR system.
 15. A methodcomprising: monitoring and interacting with a Document Object Model(DOM) of a page of an Electronic Health Record (EHR) system using abrowser extension, wherein the browser extension is configured to beexecuted by a browser, wherein the browser is configured to render thepage of the EHR system; dynamically loading a runtime infrastructure inthe page of the EHR system in a first iframe, wherein the runtimeinfrastructure lacks a Graphical User Interface (GUI) representation;dynamically loading an EHR-specific EHR adapter in the page of the EHRsystem; and dynamically loading an extending application in the page ofthe EHR system in a second iframe, wherein the browser extension isconfigured to inject the first iframe in the page of the EHR system andcause the runtime infrastructure to be loaded into the first iframe,wherein the browser extension is configured to inject the second iframein the page of the EHR system and enable the runtime infrastructure toload the extending application into the second iframe, wherein theEHR-specific EHR adapter is specifically designed based on the EHRsystem, wherein the EHR-specific EHR adapter is configured to receiveEHR-specific instructions from the browser extension and communicateconverted cross-EHR instructions to the runtime infrastructure, whereinthe runtime infrastructure is configured to communicate the convertedcross-EHR instructions to the extending application, wherein the runtimeinfrastructure is configured to receive cross-EHR instructions from theextending application, wherein the EHR-specific EHR adapter isconfigured to obtain the cross-EHR instructions and communicateconverted EHR-specific instructions to the browser extension, wherein aprocessor is configured to implement a functionality that is notprovided by the EHR system at least by: monitoring, by the browserextension, for an event in the EHR system; notifying, by the browserextension, the EHR-specific EHR adapter of the event via an EHR-specificinstruction; translating, by the EHR-specific EHR adapter, theEHR-specific instruction to a converted cross-EHR instruction that isprovided to the extending application via the runtime infrastructure;executing, by the extending application, a cross-EHR business logic inresponse to the converted cross-EHR instruction to determine a cross-EHRresponse; and translating, by the EHR-specific EHR adapter, thecross-EHR response to a converted EHR-specific instruction that can beimplemented by the browser extension over the EHR system.
 16. The methodof claim 15, wherein the extending application comprises a GUIcomponent, wherein the business logic is configured to manipulate theGUI component.
 17. The method of claim 15, wherein the extendingapplication is an automation process, wherein the automation processlacks a GUI representation.
 18. The method of claim 15 furthercomprising: retrieving from a server, by the runtime infrastructure, alist of applications to be loaded in the page, wherein the list ofapplications to be loaded comprises at least the extending application,and dynamically loading, by the runtime infrastructure, the extendingapplication in the second iframe by provisioning a Uniform ResourceLocator (URL) to be loaded in the second iframe, wherein the URL ispointing to a code of the extending application, whereby the processoris enabled to load new code and provision new functionality by changingthe code or changing the URL without changing the browser extension,whereby the processor prevents a dynamic execution of a stringrepresenting client-side code.
 19. The method of claim 18 furthercomprising determining the list of applications to be loaded based onaccess permissions of a user of the EHR system to applications in anapplication repository.
 20. The method of claim 15 further comprisingindicating, by the EHR-specific EHR adapter, an element of interest viaan indication to the browser extension, wherein the method furthercomprises monitoring the element of interest, by the browser extension,in response to the indication, wherein the method further comprisesnotifying, by the browser extension, the EHR-specific EHR adapter of theEHR-specific instruction in response to monitoring the event, whereinthe event is associated to the element of interest.